The effect of selective attention on electroencephalography responses to high-level hierarchical linguistic structures / 中国耳鼻咽喉头颈外科

OBJECTIVE To explore the neural mechanisms underlying the speech perception in individuals with normal hearing under the influence of selective attention.METHODS There were 32 individuals with normal hearing who were recruited.By manipulating the participants'selective attention,two simultaneous speech streams were differentiated into target and interfering speech.Participants were guided to complete an auditory perception electroencephalogram(EEG)experiment.Fourier spectrum analysis was used to calculate the spectrum responses induced by the two types of speech,and the differences in EEG energy values at the levels of character,word,and phrase were compared.RESULTS This study observed significant differences in the EEG responses between target and ignored speech at the word level(2 Hz),while no significant differences were observed at the character level(4 Hz)and phrase level(1 Hz).CONCLUSION In environments with multiple speech streams,selective attention primarily processes and encodes the interested speech at the word level rapidly and effectively.This study preliminarily reveals how the brain represents auditory language and constructs different language hierarchy units under the modulation of selective attention,providing a theoretical model for hearing aid algorithms in hearing-impaired patients.

Encoding of speech sounds with frequency-following response in infants with Congenital Zika Syndrome: A case-controlled study

ABSTRACT Purpose: to investigate the frequency-following response (FFR) for sustained neural activity. Methods: 39 individuals, aged between 20 to 47 months old were divided into 2 groups: (i) 20 individuals without prenatal exposure to the congenital Zika syndrome (CZS) or hydrocephaly, normal development, no risk factors for hearing loss or syndromic hearing impairment and (ii) 19 individuals diagnosed with CZS and microcephaly - based on imaging studies linked to the clinical presentation of the condition. All participants exhibited normal click-ABR tests. FFR waveforms were documented using the /da/ syllable employing the Navigator Pro. The statistical analysis used was ANOVA (p-value <0.05). Results: no distinctions were observed concerning the variables of group, age, or gender with respect to FFR latency values, except for an interaction between gender and group for latency values associated with waves V and F. Children with CZS and microcephaly showed a difference for latency values in wave V for both males and females, when compared to the control group. Conclusion: children presented with CZS and microcephaly showed higher average latencies for waves V, A, C, D and F (male) compared to the control group, whereas, in waves E, F (female) and O they showed higher values in the control group.

Tecnologia auditiva assistiva em usuários de implante coclear em ambientes reverberantes com múltiplas fontes de ruído / Assistive listening technology in cochlear implant users in reverberant environments with multiple noise sources

RESUMO Objetivo Avaliar a contribuição da tecnologia de escuta assistida em usuários de implante coclear (IC) em situações de reverberação e ruído. Métodos Estudo transversal prospectivo aprovado pelo Comitê de Ética Institucional (CAAE 8 3031418.4.0000.0068). Foram selecionados adolescentes e adultos usuários de IC com surdez pré ou pós-lingual. Para usuários bilaterais, cada orelha foi avaliada separadamente. O reconhecimento de fala foi avaliado por meio de listas gravadas de palavras dissílabas apresentadas a 65 dBA a 0° azimute com e sem o Mini Microfone2 (Cochlear™) conectado ao processador de fala Nucleus®6. A reverberação da sala foi medida como 550 ms. Para avaliar a contribuição do dispositivo de escuta assistida (DEA) em ambiente reverberante, o reconhecimento de fala foi avaliado no silêncio. Para avaliar a contribuição do DEA em reverberação e ruído, o reconhecimento de fala foi apresentado a 0° azimute com o ruído proveniente de 8 alto-falantes dispostos simetricamente a 2 metros de distância do centro com ruído de múltiplos falantes usando relação sinal-ruído de +10dB. Para evitar viés de aprendizado ou fadiga, a ordem dos testes foi randomizada. A comparação das médias foi analisada pelo teste t para amostras pareadas, adotando-se nível de significância de p<0,005. Resultados Dezessete pacientes com idade média de 40 anos foram convidados e concordaram em participar, sendo 2 participantes bilaterais, totalizando 19 orelhas. Houve contribuição positiva significante do Mini Mic2 na reverberação e ruído+reverberação (p<0,001). Conclusão DEA foi capaz de melhorar o reconhecimento de fala de usuários de IC tanto em situações de reverberação quanto ruidosas.

ABSTRACT Purpose This study aimed to evaluate the contribution of assistive listening technology with wireless connectivity in cochlear implant (CI) users in reverberating and noise situations. Methods Prospective cross-sectional study approved by the Institutional Ethics Committee (CAAE 8 3031418.4.0000.0068). Adolescents and adults CI users with pre- or post-lingual deafness were selected. For bilateral users, each ear was assessed separately. Speech recognition was assessed using recorded lists of disyllabic words presented at 65 dBA at 0° azimuth with and without the Wireless Mini Microphone 2 (Cochlear™) connected to the Nucleus®6 speech processor. Room reverberation was measured as 550 ms. To assess the contribution of the assistive listening device (ALD) in a reverberating environment, speech recognition was assessed in quiet. To assess the contribution of the ALD in reverberation and noise, speech recognition was presented at 0° azimuth along with the noise coming from 8 loudspeakers symmetrically arranged 2 meters away from the center with multi-talker babble noise using signal to noise ratio of +10dB. To avoid learning bias or fatigue, the order of the tests was randomized. Comparison of means was analyzed by t test for paired samples, adopting significance level of p <0.005. Results Seventeen patients with a mean age of 40 years were invited and agreed to participate, with 2 bilateral participants, totaling 19 ears assessed. There was a significant positive contribution from the Mini Mic2 in reverberation, and noise+reverberation (p <0.001). Conclusion ALD was able to improve speech recognition of CI users in both reverberation and noisy situations.

Simulation of hypernasality levels using trained actors: A brief communication / Simulación de niveles de hipernasalidad con actores entrenados: Una comunicación breve

ABSTRACT Purpose: to report an experience of simulation applied to a research context and assess the feasibility of using trained actors' audio recordings to simulate nasality levels. Methods: two clinical simulation actors selected and subsequently trained to simulate three nasality levels (non-nasal, mild to moderate hypernasal and severe hypernasal), resulting in a total of 6 audios. These files were analysed through a Praat script to obtain the measures A1-P0 compensated and the first formant's bandwidth. Afterwards, they were rated by two expert SLPs, according to their nasality and intelligibility, using perceptual scales. Results: according to A1-P0 and F1 bandwidth values in most conditions and the expert SLP's nasality and intelligibility ratings, the actors were able to simulate the previously defined nasality levels. Final Considerations: based on the preliminary data, it can be concluded that the use of clinical simulation in experimental contexts, offering new opportunities and benefits for researchers, is feasible. In this experience, the actors were able to simulate different nasality levels corroborated by acoustic analysis and experts' ratings.

RESUMEN Objetivo: informar una experiencia de la simulación aplicada a un contexto de investigación y evaluar la factibilidad de utilizar audios de actores entrenados para simular niveles de nasalidad. Métodos: dos actores de simulación clínica fueron seleccionados y posteriormente entrenados para simular tres niveles de nasalidad (no nasal, leve a moderado hipernasal, y severo hipernasal) dando como resultado 6 audios. Estos audios fueron analizados mediante un script de Praat para obtener las medidas A1-P0 compensado y el ancho de banda del primer formante. Posteriormente fueron calificados por dos fonoaudiólogos expertos según su nasalidad e inteligibilidad mediante escalas perceptuales. Resultados: de acuerdo con los valores de A1-P0 y ancho de banda de F1 en la mayoría de las condiciones y la evaluación de la nasalidad e inteligibilidad por los fonoaudiólogos expertos, los actores lograron simular los niveles de nasalidad previamente propuestos. Consideraciones Finales: de acuerdo con los resultados preliminares, podemos concluir que es factible utilizar la simulación clínica en contextos experimentales ofreciendo una nueva oportunidad y beneficios para los investigadores. En esta experiencia los actores lograron simular distintos niveles de nasalidad corroborado mediante análisis acústico y evaluación de expertos.

Multisensory effects of mask wearing on speech intelligibility and the benefit of multilingualism / Efeitos multissensoriais do uso de máscara na inteligibilidade da fala e o benefício do multilinguismo

ABSTRACT Purpose Due to the pandemic of the Covid-19 disease, it became common to wear masks on some public spaces. By covering mouth and nose, visual-related speech cues are greatly reduced, while the auditory signal is both distorted and attenuated. The present study aimed to analyze the multisensory effects of mask wearing on speech intelligibility and the differences in these effects between participants who spoke 1, 2 and 3 languages. Methods The study consisted of the presentation of sentences from the SPIN test to 40 participants. Participants were asked to report the perceived sentences. There were four conditions: auditory with mask; audiovisual with mask; auditory without mask; audiovisual without mask. Two sessions were conducted, one week apart, each with the same stimuli but with a different signal-to-noise ratio. Results Results demonstrated that the use of the mask decreased speech intelligibility, both due to a decrease in the quality of auditory stimuli and due to the loss of visual information. Signal-to-noise ratio largely affects speech intelligibility and higher ratios are needed in mask-wearing conditions to obtain any degree of intelligibility. Those who speak more than one language are less affected by mask wearing, as are younger listeners. Conclusion Wearing a facial mask reduces speech intelligibility, both due to visual and auditory factors. Older people and people who only speak one language are affected the most.

RESUMO Objetivo Devido à pandemia da doença Covid-19, o uso de máscaras em espaços públicos tornou-se comum. Ao cobrir a boca e o nariz, reduzem-se amplamente as pistas visuais associadas à fala, assim como se distorce e atenua o sinal auditivo. Este estudo teve como objetivo analisar os efeitos multissensoriais do uso da máscara na percepção da fala e a diferença entre participantes falantes de uma, duas ou três línguas. Método Este estudo consistiu na apresentação de frases do SPIN teste a 40 participantes. Os participantes tinham como tarefa reportar as frases percebidas em quatro condições: Auditiva com máscara, audiovisual com máscara, auditiva sem máscara, audiovisual sem máscara. Conduziram-se duas sessões, com uma semana de intervalo, cada uma com os mesmos estímulos mas com diferente relação sinal-ruído. Resultados Os resultados demonstraram que o uso de máscara reduz a inteligibilidade da fala, tanto devido à diminuição da qualidade do estímulo auditivo, como devido à perda de informação visual. A relação sinal-ruído afeta a inteligibilidade e com o uso de máscara são necessárias relações mais altas para obter qualquer identificação correta. Aqueles que falam mais do que uma língua, assim como os mais novos, são menos afetados na percepção de fala com uso de máscara. Conclusão O uso de máscara facial reduz a inteligibilidade da fala, tanto devido a fatores visuais como auditivos. Indivíduos monolíngues, assim como os mais velhos, são os mais afetados nesta tarefa.

Impact of hearing aid electroacoustic verification on speech perception and user performance in daily activities / Impacto do uso da verificação eletroacústica dos aparelhos de amplificação sonora individual na percepção de fala e desempenho do usuário nas atividades diárias

ABSTRACT Purpose: to assess the impact of electroacoustic verification on the satisfaction level and speech recognition in quiet and noise of hearing aid users. Methods: 24 individuals who had been using the device for at least 1 year and had not previously performed electroacoustic verification were assessed. In the first session, participants responded to the International Outcome Inventory for Hearing Aids validation questionnaire and indicated their satisfaction level on a visual analog scale. They were, then, subjected to speech perception tests in quiet and noise and electroacoustic verification, returning after 3 months and repeating the first stage assessments. The Wilcoxon test and paired t-test were used for data analysis, with significance set at p-value ≤ 0.05. Results: the visual analog scale assessment, the International Outcome Inventory for Hearing Aids score, the speech perception threshold in quiet and noise, and the signal/noise ratio improved after 3 months. Conclusion: individuals who had been using the device for at least 1 year had a substantial improvement in their satisfaction level and speech perception in quiet and noise after the electroacoustic verification.

RESUMO Objetivo: avaliar o impacto da verificação eletroacústica no grau de satisfação e no reconhecimento de fala no silêncio e no ruído em usuários de aparelho de amplificação sonora individual. Métodos: foram avaliados 24 usuários que utilizavam o dispositivo há pelo menos um ano e sem realização anterior de verificação eletroacústica. Em um primeiro encontro, os participantes responderam ao questionário de validação International Outcome Inventory for Hearing Aids e atribuíram uma nota de satisfação por meio da escala visual analógica. Em seguida, foram submetidos a testes de percepção de fala no silêncio e no ruído, finalizando com a realização da verificação eletroacústica. Retornaram após três meses e repetiram as avaliações da primeira etapa. Para a análise dos dados, foram utilizados os testes de Wilcoxon e Teste t pareado, valor de p ≤ 0,05. Resultados: observou-se melhora na avaliação da escala visual analógica, na pontuação do International Outcome Inventory for Hearing Aids, no limiar de percepção de fala no silêncio e ruído e na relação sinal/ruído no seguimento de três meses. Conclusão: após a verificação eletroacústica, os usuários que utilizavam o dispositivo há pelo menos um ano apresentaram melhora substancial no grau de satisfação e na percepção de fala no silêncio e no ruído.

Assessment of speech perception: A survey of speech-language-hearing therapists on their most frequent practices / Evaluación de la percepción del habla: encuesta a profesionales de la Fonoaudiología sobre sus prácticas más frecuentes

ABSTRACT Purpose: to characterize the practices of speech-language-hearing pathologists in Chile, regarding speech perception assessment in children and adolescents. Methods: an exploratory cross-sectional study carried out using a self-administered online survey to investigate knowledge and quantify trends in the practice of speech perception assessment, based on six focus groups with speech-language-hearing pathologists. The instrument was disseminated through the researchers' social media and contact networks. Descriptive statistical analysis was performed. Results: a total of 121 people responded to the survey, all of them being speech-language-hearing pathologists. These professionals, in Chile, highly value speech perception in child development, however, a large percentage of them do not assess it. Those who carry it out, reported a wide range of assessment practices. Conclusion: the results highlight the need for standardizing certain speech-language-hearing methods and the importance of understanding the assessment strategies in use to point out opportunities to improve both the assessment and subsequent therapeutic processes.

RESUMEN Objetivo: caracterizar las prácticas de los profesionales de la Fonoaudiología en Chile en torno a la evaluación de la percepción del habla en niños, niñas y adolescentes. Métodos: se realizó un estudio exploratorio de diseño transversal mediante una encuesta online autoadministrada diseñada para indagar en los saberes y cuantificar tendencias en la práctica de la evaluación de la percepción del habla. La encuesta fue confeccionada en base a seis grupos focales realizados con profesionales fonoaudiólogos. La difusión del instrumento se realizó a través de redes sociales y redes de contacto de los investigadores. El análisis estadístico realizado fue de carácter descriptivo. Resultados: un total de 121 personas respondieron la encuesta, todos profesionales de la Fonoaudiología. Los profesionales de la Fonoaudiología en Chile otorgan un alto valor a la percepción del habla en el desarrollo infantil, no obstante, un gran porcentaje no la evalúa. Aquellos profesionales que lo realizan, revelan una amplia diversidad en las prácticas evaluativas. Conclusión: los resultados permiten visibilizar la necesidad de estandarizar ciertos métodos fonoaudiológicos y resaltar la importancia de comprender las estrategias evaluativas en uso para señalar oportunidades de mejora tanto en la evaluación como en los posteriores procesos terapéuticos.

Processamento auditivo central e questionário de autopercepção pós-treinamento auditivo acusticamente controlado em indivíduos com traumatismo cranioencefálico leve / Central auditory processing and self-perception questionnaire after acoustically controlled auditory training in individuals with mild traumatic brain injury

RESUMO Objetivo Correlacionar os resultados da avaliação comportamental do processamento auditivo central e do questionário de autopercepção após o treinamento auditivo acusticamente controlado. Método Foram avaliados dez indivíduos com média de idade de 44,5 anos, que sofreram traumatismo cranioencefálico de grau leve. Os indivíduos foram submetidos a avaliação comportamental do processamento auditivo central e também responderam ao questionário de autopercepção "Treinamento Auditivo Formal" após a intervenção terapêutica. O questionário foi composto por questões referentes a percepção auditiva, compreensão de ordens, solicitação de repetição de enunciados, ocorrência mal-entendidos, tempo de atenção, desempenho auditivo em ambiente ruidoso, comunicação ao telefone e autoestima e os pacientes foram solicitados a assinalar a frequência de ocorrência dos comportamentos listados. Resultados As habilidades auditivas de figura-fundo e memória para sons em sequência e processamento temporal correlacionaram-se com melhora para seguir instruções, diminuição das solicitações de repetições e aumento do tempo de atenção e melhora da comunicação e da compreensão ao telefone e para assistir TV. Conclusão Observou-se adequação das habilidades auditivas de fechamento auditivo, figura fundo, e processamento temporal na avaliação pós-treinamento auditivo acusticamente controlado, além de redução das queixas quanto ao comportamento auditivo.

ABSTRACT Purpose To correlate behavioral assessment results of central auditory processing and the self-perception questionnaire after acoustically controlled auditory training. Methods The study assessed 10 individuals with a mean age of 44.5 years who had suffered mild traumatic brain injury. They underwent behavioral assessment of central auditory processing and answered the Formal Auditory Training self-perception questionnaire after the therapeutic intervention - whose questions address auditory perception, understanding orders, request to repeat statements, occurrence of misunderstandings, attention span, auditory performance in noisy environments, telephone communication, and self-esteem. Patients were asked to indicate the frequency with which the listed behaviors occurred. Results Figure-ground, sequential memory for sounds, and temporal processing correlated with improvement in following instructions, fewer requests to repeat statements, increased attention span, improved communication, and understanding on the phone and when watching TV. Conclusion Auditory closure, figure-ground, and temporal processing had improved in the assessment after the acoustically controlled auditory training, and there were fewer auditory behavior complaints.

Teste de palavras no ruído: confiabilidade no teste-reteste em adultos normo-ouvintes / The word-with-noise test: test-retest reliability in normal-hearing adults

RESUMO Objetivo Investigar a confiabilidade do Teste de Palavras no Ruído em um grupo de adultos normo-ouvintes. Método Participaram da pesquisa 45 sujeitos adultos normo-ouvintes. O intervalo entre a primeira e a segunda avaliação foi de 14 a 28 dias, realizadas no mesmo turno do dia e pelo mesmo avaliador. A análise de comparação entre teste e reteste foi realizada considerando o resultado geral das orelhas, totalizando 90 orelhas avaliadas. A análise inferencial incluiu a comparação das situações na primeira e segunda avaliação por meio do Teste de Wilcoxon, cálculo e interpretação do Índice de Correlação Intraclasse. Resultados Houve diferença estatisticamente significante entre os desempenhos no teste e reteste. Os coeficientes de correlação intraclasse obtidos foram indicativos de boa confiabilidade (r=0,759; p<0,001) para o estímulo monossilábico e de moderada confiabilidade (r=0,631; p<0,001) para o dissilábico. Conclusão O Teste de Palavras no Ruído demonstrou satisfatória confiabilidade tanto para o estímulo monossilábico, quanto para o dissilábico.

ABSTRACT Purpose To investigate the reliability of the Word-with-Noise Test in a group of normal-hearing adults. Methods Forty-five normal-hearing adult subjects participated in the research. The interval between the first and second assessment was 14 to 28 days, performed during the same time of the day and by the same evaluator. The comparison analysis between the test and the retest was performed considering the general result of the ears, totaling 90 ears evaluated. The inferential analysis included the comparison of the situations in the first and second assessment using the Wilcoxon Test, calculation, and interpretation of the Intraclass Correlation Index. Results There was a statistically significant difference between the test and retest performances. The intraclass correlation coefficients obtained were indicative of good reliability (r=0.759; p<0.001) for the monosyllabic stimulus and moderate reliability (r=0.631; p<0.001) for the disyllabic stimulus. Conclusion The Word-with-Noise Test demonstrated satisfactory reliability for both the monosyllabic and disyllabic stimuli.

Idosos com perda auditiva e declínio cognitivo: desempenho da percepção de fala no ruído / Elderly people with hearing loss and cognitive decline: speech perception performance in noise

RESUMO Objetivo Verificar a influência das habilidades intelectuais-cognitivas verbais na percepção de fala no ruído, em idosos com perda auditiva sensorioneural, considerando a escolaridade, a idade e o grau da perda auditiva. Método Participaram 36 idosos entre 60 e 89 anos com perda auditiva sensorioneural bilateral, que após avaliação psicológica por meio do Wechsler Intelligence Scale for Adults (WAIS III), foram divididos em (GI) 24 idosos sem alteração cognitiva e (GII) 12 idosos com risco de alteração cognitiva. Foram submetidos à avaliação otorrinolaringológica, entrevista audiológica, audiometria tonal liminar e a avaliação da percepção de fala no ruído por meio do Hearing in Noise Test (HINT-Brasil). O teste estatístico U de Mann-Whitney comparou os resultados entre os grupos, e a correlação de Spearman verificou as variáveis idade, grau da perda auditiva e nível de escolaridade. Resultados Não houve diferença entre os grupos na habilidade de percepção de fala no ruído, exceto na condição ruído à esquerda, no qual o GII apresentou melhor desempenho no HINT-Brasil. O grau da perda auditiva e o nível de escolaridade influenciaram na percepção de fala no ruído. O nível de escolaridade teve correlação com os resultados do WAIS III. Conclusão O declínio das habilidades intelectuais-cognitivas verbais não interferiu na percepção de fala no ruído nos idosos com perda auditiva. O grau da perda auditiva e o nível de escolaridade influenciaram no desempenho dos idosos no teste de percepção de fala no ruído. O desempenho nas habilidades cognitivas verbais variou com o nível de escolaridade.

ABSTRACT Purpose To verify the influence of verbal intellectual-cognitive skills on speech perception in noise, in elderly with sensorineural hearing loss, considering education, age, and degree of hearing loss. Methods 36 elderly between 60 and 89 years old with bilateral sensorineural hearing loss participated in the study. After psychological assessment using the Wechsler Intelligence Scale for Adults (WAIS-III), they were grouped into (GI) 24 elderly without cognitive alteration and (GII) 12 elderly with risk of cognitive alteration. They underwent otorhinolaryngological assessment, audiological interview, pure tone audiometry, and assessment of speech perception in noise using the Hearing in Noise Test (HINT-Brazil). The Mann-Whitney U statistical test compared the results between the groups, and the Spearman correlation verified the variable's age, degree of hearing loss, and level of education. Results There was no difference between the groups in the ability to perceive speech in noise, except in the noise on the left condition, in which GII showed better performance in HINT-Brazil. The degree of hearing loss and level of education influenced the perception of speech in noise. The level of education was correlated with the WAIS-III results. Conclusion The decline in verbal intellectual-cognitive skills did not affect speech perception of noise in the elderly with hearing loss. The degree of hearing loss and level of education influenced the performance of the elderly in the speech perception test in noise. Performance in verbal cognitive skills varied according to the level of education.

Teste de palavras no ruído: desenvolvimento, validação e valores de referência / The word-with-noise test: development, validation and reference values

RESUMO Objetivo Propor um instrumento para a avaliação do reconhecimento de fala na presença de ruído competitivo. Definir sua estratégia de aplicação, para ser aplicado na rotina clínica. Obter evidências de validade de critério e apresentar seus valores de referência. Método Estudo realizado em três etapas: Organização do material que compôs o Teste de Palavras no Ruído (Etapa 1); Definição da estratégia de aplicação do instrumento (Etapa 2); Investigação da validade de critério e definição dos valores de referência para o teste (Etapa 3), por meio da avaliação de 50 sujeitos adultos normo-ouvintes e 12 sujeitos com perda auditiva. Resultados O Teste de Palavras no Ruído é composto por listas de vocábulos mono e dissilábicos e um ruído com espectro de fala (Etapa 1). Foi definida como estratégia de aplicação do teste, a realização do Limiar de Reconhecimento de Fala com ruído fixo em 55 dBNA (Etapa 2). Quanto à validade de critério, o instrumento apresentou adequada capacidade de distinção entre os sujeitos normo-ouvintes e os sujeitos com perda auditiva (Etapa 3). Foram definidos como valores de referência para o teste, os pontos de corte expressos em relação sinal/ruído de 1,47 dB para o estímulo monossilábico e de -2,02 dB para o dissilábico. Conclusão O Teste de Palavras no Ruído demonstrou ser rápido e de fácil aplicação e interpretação dos resultados, podendo ser uma ferramenta útil a ser utilizada na rotina clínica audiológica. Além disso, apresentou evidências satisfatórias de validade de critério, com valores de referência estabelecidos.

ABSTRACT Purpose To propose an instrument for assessing speech recognition in the presence of competing noise. To define its application strategy for use in clinical practice. To obtain evidence of criterion validity and present reference values. Methods The study was conducted in three stages: Organization of the material comprising the Word-with-Noise Test (Stage 1); Definition of the instrument's application strategy (Stage 2); Investigation of criterion validity and definition of reference values for the test (Stage 3) through the evaluation of 50 normal-hearing adult subjects and 12 subjects with hearing loss. Results The Word-with-Noise Test consists of lists of monosyllabic and disyllabic words and speech spectrum noise (Stage 1). The application strategy for the test was defined as the determination of the Speech Recognition Threshold with a fixed noise level at 55 dBHL (Stage 2). Regarding criterion validity, the instrument demonstrated adequate ability to distinguish between normal-hearing subjects and subjects with hearing loss (Stage 3). Reference values for the test were established as cut-off points expressed in terms of signal-to-noise ratio: 1.47 dB for the monosyllabic stimulus and -2.02 dB for the disyllabic stimulus. Conclusion: The Word-with-Noise Test proved to be quick to administer and interpret, making it a useful tool in audiological clinical practice. Furthermore, it showed satisfactory evidence of criterion validity, with established reference values.

The Effects of Monaural Stimulation on Frequency-Following Responses in Adults Who Can Sing in Tune and Those Who Cannot

Abstract Introduction Musicians have an advantage over non-musicians in detecting, perceiving, and processing nonverbal (i.e., environmental sounds, tones and others) and verbal sounds (i.e., consonant, vowel, phrases and others) as well as instrumental sounds. In contrast to the high skill of musicians, there is another group of people who are tone-deaf and have difficulty in distinguishing musical sounds or singing in tune. These sounds can originate in different ways, such as a musical instrument, orchestra, or the human voice. Objectives The objective of the present work is to study frequency-following responses (FFRs) in individuals who can sing in-tune and those who sing off-tune. Methods Electrophysiological responses were recorded in 37 individuals divided in two groups: (i) control group (CG) with professional musicians, and (ii) experimental group (EG) with non-musicians. Results There was homogeneity between the two groups regarding age and gender. The CG had more homogeneous responses in the latency of the FFRs waves when responses between the right and left ears were compared to those of the EG. Conclusions This study showed that monaural stimulation (right or left) in an FFR test is useful for demonstrating impairment of speech perception in individuals who sing off tune. The response of the left ear appears to present more subtlety and reliability when identifying the coding of speech sound in individuals who sing off tune.

Bluetooth Coupling in Hearing Aids: Effect on Audiovisual Speech Recognition and Quality Rating of Compressed Speech in Older Individuals with Sloping Hearing Loss

Abstract Introduction Older individuals often report that they find it difficulty in enjoying watching television since they find it hard to follow the rapid intensity variations, and voice changes from scene to scene. Objective The present study investigated the effect of coupling the hearing aid with the television via Bluetooth on audiovisual speech recognition and quality rating of compressed speech in older individuals with hearing loss. Method Twenty participants in the age range of 60 to 75 years who had moderate to moderately severe sloping sensorineural hearing loss were bilaterally fitted with digital receiver in the canal hearing aids. The hearing aid was coupled with a television via Bluetooth using a streamer. The video recorded stimuli were presented at 65 dB SPL at normal rate, 35% compression and 45% compression conditions. Speech recognition scores and quality ratings were obtained for each condition with and without the Bluetooth streamer connected to the hearing aids. Results Speech recognition scores were significantly better with Bluetooth coupling compared with conventional hearing aid use at 40% compressed speech rate. The quality was also rated higher in almost all parameters across speech rates when Bluetooth was used. Conclusions The improved clarity and nullification of room reverberation offered by Bluetooth coupling can potentially compensate for the age-related temporal processing deficit contributing to ease of listening.

The functional mechanisms of the central auditory nervous system in human speech development / 中华行为医学与脑科学杂志

The development of speech is a process by which the neural network structure of brain perceives, decodes, represents, and outputs input signals. At the cortical level, the classic model of speech processing proposed two pathways leading from the auditory system: the ventral stream and the dorsal stream.The ventral stream, which involved structures in the superior and middle portions of the temporal lobe, was involved in processing speech signals for perception and comprehension (speech recognition). The dorsal stream, which involved structures in the posterior frontal lobe and the posterior dorsal-most aspect of the temporal lobe and parietal operculum, had an auditory-motor integration function and was essential for speech production. However, the importance of auditory processing in central auditory nervous system(CANS) from the vestibulocochlear nerve to the auditory cortex for speech development had not been clarified.This review aims to discuss the roles and related mechanisms of the CANS in speech recognition and generation from the perspective of cognitive neuroscience, so as to provide new ideas for clinical monitoring and long-term prediction of auditory processing and speech development, and for diagnosis and treatment of clinical speech-related diseases.

Resistance to the use of the FM System by children and adolescents: fact or myth? An analysis of records of patients assisted in a hearing health center / Resistência ao uso do Sistema FM por crianças e adolescentes: fato ou mito? Uma análise de prontuários de pacientes atendidos em um serviço de saúde auditiva

ABSTRACT Purpose: to compare the use of the Frequency Modulation (FM) System by children and adolescents in a public hearing health center in the state of São Paulo. Methods: the analysis of medical records based on eligibility criteria. Data were collected from 340 participants born between 1998 and 2011, fitted with FM System, and who attended the follow-up appointment after fitting the device. Data were analyzed descriptively and inferentially. Results: hard-of-hearing children and adolescents of both genders from all over Brazil, attending elementary, middle or high school in public or private schools, participated. The data showed that 115 children and 155 adolescents effectively used the device, especially at school. The main difficulty for children was the lack of support from teachers; for adolescents, it was the feeling of embarrassment. Conclusion: some difficulties, especially on children, in adhering to the use of FM Systems were identified. Hence, to ensure the FM System's effective use, the importance of providing guidance and awareness of its benefits to patients, and their family members and teachers, during the fitting appointment and follow-up consultations, is emphasized.

RESUMO Objetivo: comparar o uso do Sistema de Frequência Modulada por crianças e adolescentes em um Serviço Público de Saúde Auditiva do estado de São Paulo. Métodos: análise de prontuários, balizada pelos critérios de elegibilidade. Foram coletados dados de 340 participantes adaptados com o Sistema de Frequência Modulada, nascidos entre 1998 e 2011 e que compareceram à consulta de retorno pós-adaptação do dispositivo. Os dados foram analisados de forma descritiva e inferencial. Resultados: participaram crianças e adolescentes de ambos os gêneros provenientes de todo Brasil, com deficiência auditiva, cursando o ensino fundamental I ou II e ensino médio na rede pública ou privada de ensino. Os dados revelaram que 115 crianças e 155 adolescentes faziam uso efetivo do dispositivo, especialmente na escola. As principais dificuldades relatadas foram a falta de apoio dos professores entre as crianças e o sentimento de vergonha entre os adolescentes. Conclusão: foram identificadas dificuldades na adesão ao uso do Sistema FM, sobretudo por parte das crianças. Diante disso, ressalta-se a importância da orientação e da conscientização dos benefícios do uso do Sistema FM aos pacientes, familiares e seus professores, tanto no momento da adaptação do dispositivo quanto nas consultas de acompanhamento, a fim de assegurar o seu uso efetivo.

Speech perception and spoken language of children with auditory neuropathy spectrum disorder: a systematic literature review / Percepção da fala e linguagem de crianças com espectro da neuropatia auditiva: revisão sistemática da literatura

ABSTRACT Purpose: to analyze the test results of speech perception and spoken language in children with hearing loss and auditory neuropathy spectrum disorder, users of hearing aids or cochlear implants. Methods: a systematic review of the literature based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Consultation was performed in databases, considering studies from 1996 to 2021, selecting the studies that presented the results of speech perception or spoken language in children with bilateral auditory neuropathy spectrum disorder, with no structural alterations of the ear and/or vestibulocochlear nerve, or other associated impairments. Descriptive analysis was performed. Literature Review: among 1,422 studies found, 15 were included. Variability in the sample size, types of studies, evaluation procedures and methodological questions were observed. The cochlear implants and hearing aids contributed to the development of speech perception and spoken language in children with auditory neuropathy spectrum disorder, since skills such as auditory comprehension and speech intelligibility, were achieved. Conclusion: 15 studies suggest that cochlear implants and hearing aids may be effective for speech perception and spoken language development in children with auditory neuropathy spectrum disorder, with no other associated impairments. The need for further research with a high methodological rigor is highlighted.

RESUMO Objetivo: analisar os resultados de testes percepção da fala e linguagem falada de crianças com espectro da neuropatia auditiva, usuárias de aparelho de amplificação sonora individual ou implante coclear. Métodos: revisão sistemática da literatura, baseada no guideline Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Levantaram-se, em bases de dados, estudos entre 1996 e 2021, que apresentavam os resultados de percepção da fala ou linguagem falada de crianças com espectro da neuropatia auditiva bilateral, sem alterações estruturais da orelha/nervo vestíbulo-coclear, ou comprometimentos associados. Os dados foram analisados descritivamente. Revisão da Literatura: dentre 1422 estudos encontrados, 15 foram incluídos. Observou-se variabilidade no tamanho das amostras, tipos de estudos, procedimentos de avaliação e questões metodológicas. O implante coclear e o aparelho de amplificação sonora individual contribuíram para o desenvolvimento da percepção da fala e linguagem falada de crianças com espectro da neuropatia auditiva, pois foram alcançadas habilidades, como a compreensão auditiva e inteligibilidade da fala. Conclusão: 15 estudos sugeriram que o implante coclear e o aparelho de amplificação sonora individual podem ser efetivos para o desenvolvimento da percepção da fala e linguagem falada de crianças com espectro da neuropatia auditiva sem outros comprometimentos associados. Ressalta-se a necessidade de pesquisas com alto rigor metodológico.

O benefício do mascaramento modulado nos potenciais evocados auditivos corticais com estímulo de fala / Masking release in cortical auditory evoked potentials with speech stimulus

RESUMO Objetivo analisar o efeito do mascaramento estável e modulado no Potencial Evocado Auditivo Cortical com estímulo de fala em adultos-jovens. Método participaram 14 indivíduos com idades entre 19 e 28 anos de ambos os sexos e sem perda auditiva. O exame de Potencial Evocado Auditivo Cortical foi realizado com estímulo de fala sintética /ba/ simultâneo ao ruído Speech Shaped Noise apresentado em três condições: ruído estável com intensidade de 30 dB NPSpe (ruído estável fraco), ruído estável com intensidade de 65 dB NPSpe (ruído estável forte) e ruído modulado em intensidade de 30 dB NPSpe e 65 dB NPSpe em 25Hz e com período de modulação de 40 ms. Resultados foram observadas maiores latências nos componentes corticais, exceto P2, na condição de ruído estável forte e medidas mais robustas de amplitude dos componentes corticais P1, N1 e P2 na condição de ruído modulado com diferença estatística significativa na comparação com a condição de ruído estável forte. Houve pior morfologia na condição de ruído estável forte, quando comparado aos demais registros. Os limiares eletrofisiológicos médios para as condições de ruído estável forte e ruído modulado foram 60 dB NPSpe e 49 dB NPSpe, respectivamente, mostrando 11,7 dB de diferença média. Conclusão podemos inferir que houve um menor efeito mascarante do ruído modulado, comparado à condição de ruído estável forte, nas medidas de amplitude dos componentes corticais e uma diferença média de 11,7 dB entre os limiares eletrofisiológicos (interpretado como a medida do Benefício do Mascaramento Modulado).

ABSTRACT Purpose To analyze the effect of masking on the Cortical Auditory Evoked Potential with speech stimulus in young adults. Methods Fourteen individuals aged between 19 and 28 years of both sexes with no hearing loss participated in the study. The Cortical Auditory Evoked Potential examination was performed with synthetic speech stimulus /ba/ simultaneous to Speech Shaped Noise presented under three conditions: steady noise with a 30 dB SPLep intensity (weak steady noise), steady noise with a 65 dB SPLep intensity o (strong steady noise) and modulated noise with 30 dB SPLep and 65 dB SPLep intensities at 25Hz and modulation period of 40 ms. Results Higher latencies were observed in the cortical components, except P2, in the condition of strong steady noise and more meaningful measures of amplitude of the cortical components P1, N1 and P2 in the condition of modulated noise with statistically significant difference in comparison to the strong steady noise condition. There was worse wave morphology in the condition of strong steady noise, when compared to the other records. The average electrophysiological thresholds for the conditions of strong steady noise and modulated noise were 60 dB SPLep and 49 dB SPLep, respectively, showing a 11.7 dB mean difference. Conclusion We could infer that there was a lower masking effect of modulated noise when compared to the strong steady noise condition, in the amplitude measurements of the cortical components and an average difference of 11.7 dB between the electrophysiological thresholds (interpreted as the measure of the Masking Release).

Benefits of Bimodal Stimulation to Speech Perception in Noise and Silence

Abstract Introduction Understanding all the benefits of bimodality with self-assessment questionnaires on the effect of hearing on quality of life is still necessary. Objective To present whether bimodality still offers hearing benefits to the population who uses acoustic stimulation associated with electrical stimulation. Methods The present study included 13 participants aged between 16 and 80 years old who were users of cochlear implants from Cochlear Corporation and hearing aids. All patients underwent the Hearing in Noise Test, and their visual analog scale score was obtained. Four-tone means were collected, and the participants answered the Speech, Spatial and Hearing Qualities questionnaire. Results Bimodal users had an average sentence recognition rate of 76.0% in silence and 67.6% in fixed noise, and the signal-to-noise ratio in adaptive noise was +2.89dB. In addition, a lower level of difficulty was observed in the test using the visual analog scale. The domain with the highest average was auditory qualities (6.50), followed by spatial hearing (6.26) and hearing for speech (5.81). Individuals with an average between 50 and 70 dB of hearing level showed better sentence recognition in silence and noise. Conclusion Bimodal stimulation showed benefits for users with different degrees of hearing loss; however, individuals who presented greater hearing residue had better performance in speech recognition with noise and in silence in addition to a good perception of hearing quality.

Habilidades de processamento auditivo central e exame pericial de comparação de locutor / Central auditory processing skills and speaker comparison in forensic analysis

RESUMO Objetivo descrever quais são as habilidades auditivas do processamento auditivo central mais frequentes, relatadas por um grupo de especialistas para a realização do exame de Comparação de Locutor, tradicionalmente realizado por peritos forenses. Métodos estudo prospectivo, descritivo, com análise quantitativa e qualitativa. Os dados foram obtidos por meio de um consenso de especialistas. Participaram da reunião cinco fonoaudiólogos, sendo dois especialistas em audiologia, dois especialistas em voz e uma fonoaudióloga perita. A reunião foi realizada de forma virtual e síncrona, com duração de uma hora e 30 minutos. As tarefas realizadas durante o exame de Comparação de Locutor foram consideradas a partir de um protocolo disponível na literatura. As especialistas em fonoaudiologia receberam explicações a respeito de cada uma das tarefas e foram solicitadas a discutir sobre quais as habilidades do processamento auditivo central estariam envolvidas na execução de cada uma delas. Resultados sete habilidades foram consideradas na reunião dos especialistas como imprescindíveis para as tarefas realizadas no exame de Comparação de Locutor. A ordenação temporal foi a habilidade mais citada, podendo estar presente em seis tarefas, e a tarefa de transcrição do material de fala foi mencionada como sendo a que necessita de mais habilidades do processamento auditivo central. Conclusão Sete habilidades foram consideradas na reunião dos especialistas como imprescindíveis para as tarefas realizadas no exame de Comparação de Locutor. A ordenação temporal foi a habilidade mais citada, podendo estar presente em seis tarefas e a tarefa de transcrição do material de fala foi mencionada como sendo a que necessita de mais habilidades do processamento auditivo central

ABSTRACT Purpose to describe which abilities of central auditory processing are more frequently related for the group of specialists to the performance of the speaker comparison test (CL), traditionally performed by forensic experts. Methods a prospective, descriptive study with quantitative and qualitative analysis and data were obtained through a consensus of experts. Five speech therapists participated in the meeting, two specialists in audiology (EA), two specialists in voice (VS), and an expert speech therapist (FP). The meeting was held virtually and synchronously, lasting 1 hour and 30 minutes. The tasks performed during the Speaker Comparison (LC) exam were considered from a protocol available in the literature. The AEs received explanations about each of the tasks and were asked to discuss which auditory processing skills (ACP) would be involved in the performance of each of them. Results seven PAC skills were considered in the experts' meeting as essential for the tasks performed in the CL exam. Temporal ordering was the most cited skill, being present in six tasks, and the speech material transcription task is the one that requires more skills from the PAC. Conclusion Seven PAC skills were considered in the experts' meeting as essential for the tasks performed in the CL exam. Temporal ordering was the most cited skill, being present in six tasks, and the speech material transcription task is the one that requires more skills from the PAC.

Autorrelato de dificuldades auditivas e desempenho em teste de fala com ruído - o que podemos encontrar por trás de um audiograma "normal"? / Self-reported hearing difficulties and speech-in-noise test performance - what can we find behind a "normal" audiogram?

RESUMO Objetivo Investigar a queixa de dificuldade de inteligibilidade na presença de ruído, em sujeitos sem perda auditiva e compará-la com o desempenho em um teste de fala no ruído. Método A casuística foi constituída por 39 sujeitos de 18 a 59 anos e 11 meses foram divididos em quatro grupos em função da década de vida. Estes foram submetidos à audiometria, timpanometria, testes de processamento auditivo, mini exame do estado mental, autorrelato da percepção auditiva com o Pt-AIADH e a um teste de sentenças no silêncio e no ruído. Resultados Todos os grupos pontuaram para os domínios do Pt-AIADH, com maior pontuação média para o domínio de inteligibilidade no ruído. Houve diferenças entre o G18 vs G40, G18 vs G50, e G30 vs G50 para a autopercepção auditiva na inteligibilidade no ruído; e diferenças entre o G18 e os demais grupos no teste de fala com ruído, com menor relação sinal-ruído para os adultos mais velhos. Houve correlação moderada e significativa para a inteligibilidade no ruído e o teste de fala no ruído. Conclusão Normo-ouvintes de todas as faixas etárias estudadas apresentaram queixa de inteligibilidade no ruído. Quanto maior a dificuldade auditiva neste domínio pior o desempenho no teste de fala com ruído, sendo mais significativo em adultos de meia idade.

ABSTRACT Purpose To investigate complaints of difficulty understanding speech in the presence of noise in subjects without hearing loss and their performance on a speech-in-noise test. Methods Thirty-nine subjects aged 18 to 59 years and 11 months were divided into four groups according to their decade of life. They underwent audiometry, tympanometry, auditory processing tests, the Mini-Mental State Examination, a self-report on auditory perception combined with the Amsterdam Inventory for Auditory Disability and Handicap (Pt-AIADH), and a sentence test in silence and in noise. Results All groups scored high on the Pt-AIADH domains, with the highest average score obtained for the noise intelligibility domain. There were differences between G18 vs. G40, G18 vs. G50, and G30 vs. G50 for auditory self-perception in noise intelligibility, and differences between the youngest and all other groups on the speech-in-noise test in particular, with a lower signal-to-noise ratio for older adults. We also identified a moderate and significant correlation between intelligibility in noise and the speech-in-noise test. Conclusion Normal hearers of all age groups complained of intelligibility in noise. We found that the higher an individual's auditory difficulty in this domain, the worse their performance on the speech-in-noise test; this is especially true for middle-aged adults.