The effect of remote fitting technology on hearing aid satisfaction

Background: Telemedicine is a method of providing remote healthcare services and consultations to patients using communication technology. Tele-audiology is a sub-branch of telemedicine. It refers to providing audiology services using telehealth strategies. This study aims to compare the satisfaction of patients who come to the hearing aid center and receive device fitting service and patients who have hearing aid fitting using tele-audiology service. For this purpose, hearing aid users were divided into two groups. The study group consisted of 17 participants (10 male, 7 females;mean age 65.17 +/- 13.88) who continued fitting appointments remotely after the first clinic application, while the control group consisted of 23 participants (10 males, 13 females;mean age 62.17 +/- 18.32) who had all hearing aid fittings performed face-to-face in the clinic. The participant's satisfaction was assessed with The International Outcome Inventory for Hearing Aids Turkiye (IOI-HA-TR) questionnaire because it is practical and can be administered over the phone. Result(s): There were no significant differences in hearing aid satisfaction between those who came to the hearing center and filled out the IOI-HA-TR questionnaire personally and those who completed it through the Remote Care application (p < 0.05). In addition, most of the participants stated that using Remote Care solved their problems (35% very good, 24% good) and they were satisfied with the fitting of their hearing aids with this application (35% good, 29% very good). In addition, 13 out of 17 participants stated that they would pay attention to the "remote fitting" feature when purchasing a new hearing aid (76% very good). Moreover, they would like to continue the fitting using the Remote Care application (65% yes). Conclusion(s): Remote fitting technology via smartphone applications can facilitate the lives of hearing aid users and improve their quality of life in cases of risky conditions such as pandemics, various diseases, and physical limitations.Copyright © 2023, The Author(s).

Utilisation of tele-audiology practices in Australia during the COVID-19 pandemic: Perspectives of audiology clinic owners, managers and reception staff.

OBJECTIVE: To canvas the views of Australia-based hearing healthcare clinic owners/managers and reception staff regarding the utilisation, experiences and perspectives of providing tele-audiology services during the COVID-19 pandemic. DESIGN: A national prospective self-report survey was completed online. Data were analysed using descriptive statistics. STUDY SAMPLE: Twenty-one clinic owners/managers (Mage 54.43 years, 15 female) and 58 reception staff (Mage 42.88 years, 49 female) from Australia-based hearing clinics. RESULTS: Clinic owners/managers reported an increase in use of tele-audiology services as compared to pre-COVID-19. Reception staff reported providing more advice and support to clients over the phone. Both clinic owners/managers and reception staff indicated key barriers to providing tele-audiology services to include concerns about their clients' digital and technological literacy and the perception that in-the-clinic appointments deliver better client outcomes than tele-audiology appointments. CONCLUSIONS: The increased utilisation of tele-audiology services observed appears to be largely influenced by COVID-19 related factors (e.g. maintaining client and staff safety and increased funding). It is therefore possible that utilisation of tele-audiology service may drop once the threat of the pandemic has subsided. Perceived barriers relating to clients' digital literacy and the effectiveness of tele-audiology services require attention to safeguard the future of tele-audiology service delivery in Australia.

Changes in audiologists' mental wellbeing during the COVID-19 pandemic: the supportive role of professional associations, workplaces and hearing device manufacturers.

Objective: The purpose of this study was to explore whether self-reported mental wellbeing (anxiety, depression and loneliness) in audiologists has changed over the course of the COVID-19 pandemic and to examine possible factors contributing to audiologists' current state of mental wellbeing.Design: Two cross-sectional surveys were distributed at two different time points during the COVID-19 pandemic screening for psychological distress (PHQ-4: anxiety and depression) and loneliness (UCLA-3).Study sample: 117 audiologists from around the world.Results: Findings demonstrated that over the course of the COVID-19 pandemic audiologists' levels of depression decreased, levels of anxiety were low and stable, whilst levels of loneliness were stable and high. Younger age was associated with lower levels of mental well-being. Responses to open text questions suggests that audiologists could be supported through development of clear and consistent guidelines on COVID-19 workplace restrictions, allowing for more workplace flexibility and providing mental health support through employee assistance programs.Conclusions: The rates of anxiety, depression and loneliness observed highlight the continued need for mental health and workplace interventions to support audiologists throughout the COVID-19 pandemic and the subsequent recovery period.

Erratum: Conducting clinical research in the era of the COVID-19 pandemic: Challenges and lessons for Speech-Language Pathology and Audiology research.

No abstract available.

Impact of COVID-19 Pandemic on Older Adults Using Hearing aid/s: Indian Scenario.

The present study explored the impact of COVID-19 on hearing health and problems faced by older adults using hearing aid/s. Fifty older adults in the age range of 55-95 years were selected for the study based on the inclusion and exclusion criteria. Therefore, the developed questionnaire was administered to them. Statistical analysis was performed for all the responses achieved. Closure of hearing aid companies and audiological centers was found to have a negative impact on availing audiological services. Likewise, a huge hike in the price of these services made it impossible for people to afford them. Despite the availability of tele-audiology, older adults were not able to make the best use of it due to numerous reasons. We sought to explore patients' perceptions to break down these barriers by enhancing the quality of tele-audiology, home visits, and remote services. Therefore, the present report may facilitate in planning and implementation of policies related to audiological services, especially during times of crisis, which may help strengthen our hearing health care system. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-022-03209-8.

Tele-Audiology: Current State and Future Directions.

The importance of tele-audiology has been heightened by the current COVID-19 pandemic. The present article reviews the current state of tele-audiology practice while presenting its limitations and opportunities. Specifically, this review addresses: (1) barriers to hearing healthcare, (2) tele-audiology services, and (3) tele-audiology key issues, challenges, and future directions. Accumulating evidence suggests that tele-audiology is a viable service delivery model, as remote hearing screening, diagnostic testing, intervention, and rehabilitation can each be completed reliably and effectively. The benefits of tele-audiology include improved access to care, increased follow-up rates, and reduced travel time and costs. Still, significant logistical and technical challenges remain from ensuring a secure and robust internet connection to controlling ambient noise and meeting all state and federal licensure and reimbursement regulations. Future research and development, especially advancements in artificial intelligence, will continue to increase tele-audiology acceptance, expand remote care, and ultimately improve patient satisfaction.

Cohort profile: Netherlands Longitudinal Study on Hearing (NL-SH).

PURPOSE: The Netherlands Longitudinal Study on Hearing (NL-SH) was set up to examine associations of hearing ability with psychosocial, work and health outcomes in working age adults. PARTICIPANTS: Inclusion started in 2006 and is ongoing. Currently the sample comprises 2800 adults with normal and impaired hearing, aged 18-70 years at inclusion. Five-year follow-up started in 2011, 10-year follow-up in 2016 and 15-year follow-up in 2021. All measurements are web-based. Participants perform a speech-in-noise recognition test to measure hearing ability and fill out questionnaires about their hearing status, hearing aid use, self-reported hearing disability and coping, work status and work-related outcomes (work performance, need for recovery), physical and psychosocial health (depression, anxiety, distress, somatisation, loneliness), healthcare usage, lifestyle (smoking, alcohol), and technology use. FINDINGS TO DATE: The NL-SH has shown the vast implications of reduced hearing ability for the quality of life and health of working-age adults. A selection of results published in 27 papers is presented. Age-related deterioration of hearing ability accelerates after the age of 50 years. Having a history of smoking is associated with a faster decline in hearing ability, but this relationship is not found for other cardiovascular risk factors. Poorer hearing ability is associated with increased distress, somatisation, depression and loneliness. Adults with impaired hearing ability are more likely to be unemployed or unfit for work, and need more time to recuperate from work effort. FUTURE PLANS: Participant data will be linked to a national database to enable research on the association between hearing ability and mortality. Linking to environmental exposure data will facilitate insight in relations between environmental factors, hearing ability and psychosocial outcomes. The unique breadth of the NL-SH data will also allow for further research on other functional problems, for instance, hearing ability and fall risk. TRIAL REGISTRATION NUMBER: NL12015.029.06.

Phase 1 of collaborative action around the implementation of virtual hearing aid care: Development of a clinical practice guideline.

RATIONALE: There is a growing demand for comprehensive, evidence-based, and accessible clinical practice guidelines (CPGs) to address virtual service delivery. This demand was particularly evident within the field of hearing healthcare during the COVID-19 pandemic, when providers were faced with an immediate need to offer services at a distance. Considering the recent advancement in information and communication technologies, the slow uptake of virtual care, and the lack of knowledge tools to support clinical integration in hearing healthcare, a Knowledge-to-Action Framework was used to address the virtual care delivery research-to-practice gap. AIMS AND OBJECTIVES: This paper outlines the development of a CPG specific to provider-directed virtual hearing aid care. Clinical integration of the guideline took place during the COVID-19 pandemic and in alignment with an umbrella project aimed at implementing and evaluating virtual hearing aid care incorporating many different stakeholders. METHOD: Evidence from two systematic literature reviews guided the CPG development. Collaborative actions around knowledge creation resulted in the development of a draft CPG (v1.9) and the mobilisation of the guideline into participating clinical sites. RESULTS AND CONCLUSION: Literature review findings are discussed along with the co-creation process that included 13 team members, from various research and clinical backgrounds, who participated in the writing, revising, and finalising of the draft version of the guideline.

Phase 2 of collaborative action around the implementation of virtual hearing aid care: Evaluation of a clinical practice guideline.

RATIONALE: Following the onset of the COVID-19 pandemic, a clinical practice guideline (CPG) around virtual hearing aid practices was developed to fill a knowledge gap within the field of audiology. Details outlining the development and mobilization of this draft guideline were outlined as Phase 1 (described in a paired paper). AIMS AND OBJECTIVES: This study describes Phase 2 of this project as part of the Knowledge-to-Action Framework, including an evaluation of the methodological quality of the guideline and the resulting tailored version of the document (v2.0). METHOD: The Appraisal of Guidelines for Research and Evaluation II instrument was used to assess methodological quality and to guide revisions. Twenty-two clinicians, from a variety of clinical backgrounds, participated in the evaluation. RESULTS AND CONCLUSION: Findings reported across six domains suggest high mean scores, ranging from 78% to 81%, in order of scope and purpose (highest rated), stakeholder involvement, rigour of development, applicability, clarity of presentation, and editorial independence. Specific recommendations made by in international co-creation team during the evaluation informed the final version of the CPG. Future development and evaluation efforts should aim to include greater representation from nontraditional practice contexts to strengthen global applicability.

Defining a Patient-Centred Core Outcome Domain Set for the Assessment of Hearing Rehabilitation With Clients and Professionals.

Background: A variety of outcome domains are currently measured for the assessment of hearing rehabilitation. To date, there is no consensus about which outcome domains should be measured, when they should be measured, and how they should be measured. In addition, most studies seeking to develop core outcome sets and measures for hearing rehabilitation services have primarily focussed on the opinions and expertise of researchers, and, to a lesser extent, clinicians, rather than also involving clients of those services. The principles of experience-based co-design suggest that health services, researchers, and policymakers should come together with clients and their families to design health services and define what metrics should be used for their success. Objectives: This study aimed to seek views and consensus from a range of key stakeholders to define which client-centred self-report outcome domains should be measured, when they should be measured, and how they should be measured, in a national publicly funded hearing rehabilitation scheme. In addition, the study aimed to identify current and future potential mechanisms and systems to standardise the collection of data and reporting of outcomes, to enable comparison across clients and hearing service providers. Methods: Two stakeholder groups participated in a three-round online Delphi process: (1) 79 professional stakeholders involved in the delivery of hearing services in Australia, and (2) 64 hearing rehabilitation services' clients identified by not-for-profit consumer organisations. An initial set of in-person workshops scoped the key issues upon which to develop the initial open-ended questions and subsequent Likert-scale statements addressing these issues. These statements were then distributed to both groups in an online survey. The respondent ratings were summarised, and the summary was returned to respondents along with a second round of the survey. This process was then repeated once more. The five most important outcome domains from both groups were then combined, and a consensus workshop of seven professionals and three client advocates agreed on the top four ranked domains. Results: A range of potential outcome domains were identified as relevant indicators of successful hearing rehabilitation. Communication ability, personal relationships, wellbeing, and participation restrictions were identified as a core outcome domain set that should be measured as a minimum for patients receiving hearing rehabilitation. There was little agreement on the preferred timepoints for collection of outcome measures, with respondents expressing the view that this should be established by research once a set of outcome measures has been selected. However, there was broad agreement that measurements of these domains should be collected at baseline (before the provision of hearing rehabilitation) and no earlier than 3 months following the completion of rehabilitation. Potential benefits and issues with the development of a national outcomes database/collection system were also identified and prioritised, with participants highlighting the importance of valid, high-quality, trustworthy, and comprehensive data collection. Conclusion: These results provide a Core Outcome Domain Set for the self-reported evaluation of hearing rehabilitation and provide important background information for the design of methods to implement them across hearing healthcare systems. However, the wide range of outcome domains identified as potentially providing important additional information and the lack of specific measures to address these domains strongly suggest that there is still more research to be done. Ongoing stakeholder engagement will continue to be vital for future implementation. In addition, further research is required to determine the optimal time following hearing rehabilitation to utilise any particular outcome measure.

Validation and optimization of an audiometry simulator prototype for phonoaudiology students (SAEF) in pandemic times

This study presents the validation and optimization of an audiometry simulator for phonoaudiology students (SAEF v.1), which is a software designed to develop procedural audiometry skills. Student learning autonomy to conduct this exam is challenging due to the high equipment costs, especially in times of the COVID-19 pandemic. Users and experts validate the simulator and determine the information technology acceptance, the correct procedure of the audiometric exam emulated by the simulator, the feedback granted, the compliance with learning outcomes, among others. As a result, users showed high acceptability of the software and highlighted that its creation complies with the standards of emulation of the audiometry procedure according to international standard. It is concluded that the new SAEF v.2 provides functional and interface improvements to deliver a greater similarity between the simulated and the real instrument. © 2023,Formacion Universitaria. All Rights Reserved.

Hearing screening test in neonates born to COVID-19-positive mothers.

SARS-CoV-2, the responsible virus for the COVID-19 pandemic, has demonstrated neurotropic properties indicated by cases presenting with auditory and vestibular system insults. The expression of ACE-2 receptors in the placenta and the detection of IgM antibodies against the virus in the fetuses of pregnant women suffering from COVID-19 render vertical transmission of the infection to the fetus possible. Thus, our study aims to examine whether, similar to other viruses like CMV, SARS-CoV-2 is responsible for congenital hearing loss. This is a retrospective study in a regional pediatric hospital. The medical records of newborns (n = 111) born by mothers positive for COVID-19 during pregnancy who underwent screening hearing tests with Transient Evoked Otoacoustic Emissions (TEOAE) and Automatic Auditory Brainstem Response (AABR) from February 2020 to June 2022 were reviewed. Neonates with additional aggravating factors for congenital hearing loss were excluded from the study. For the study period, nine mothers were found positive during the first trimester, twenty mothers in the second trimester, and eighty-three mothers in the third trimester. TEOAEs test and AABR test scored PASS bilaterally in all neonates tested. CONCLUSION: Infection with COVID-19 during pregnancy was not a risk factor for hearing loss, similar to other studies. WHAT IS KNOWN: • The pathogenetic mechanism of the viral-induced impairment of the organ of Corti includes direct damage to the hair cells and indirect damage due to the induction of the innate inflammatory response. • Early data suggested that the SARS-CoV-2 virus also has neurotropic properties with manifestations from the sensory epithelia. WHAT IS NEW: • Although the intrauterine infection remains controversial, the expression of the ACE-2 receptor on the placenta and the detection of IgM antibodies, as well as the covid-19 genome in fetuses, make the vertical transmission tenable. • In our study, the newborn hearing screening results indicate that COVID-19 infection during pregnancy is not a risk factor for hearing loss.

Audiological Assessment in Post COVID-19 Patients- A Cross-sectional Study

Introduction: Hearing loss following a viral infection is a common entity. In recent studies, hearing loss has been seen among Coronavirus Disease 2019 (COVID-19) infected patients, but its association is yet to be established. Aim: To determine the presence of hearing loss and its type in patients after COVID-19 infection. Materials and Methods: A cross-sectional study was conducted at a tertiary health centre, Department of Otorhinolaryngology at Chettinad Academy of Research and Education, Chettinad Hospital and Research Institute, Chennai, from October 2021 to April 2022. Total of 125 patients, who had a positive history of COVID-19 infection, were reviewed in the Otorhinolaryngology Department, one month after they were tested Real Time-Polymerase Chain Reaction (RT-PCR) positive. After obtaining proper clinical history and examination, Pure Tone Audiometry (PTA) were done. Audiological report was assessed and analysed. Qualitative variables will be expressed in proportions and quantitative variables in Mean±SD/ Median (IQR), Chi- square test was applied. Results: This study included 65 males (52%) and 60 females (48%), and the mean age was 38.44±10.9 years years. Among the 125 patients, 12 (9.6%) were diabetic, 14 (11.2%) were hypertensive, 5 (4%) had dyslipidaemia, 3 (2.4%) were hypothyroid, while remaining 91 patients (72.8%) had no co-morbidities. Sensorineural Hearing Loss (SNHL) was found among 45 patients (34 with unilateral and 11 with bilateral involvement). Out of them, 2 (4.5%) (4.5%) were in the age group of 18-30 years, 19 (42.2%) in 31-45 years and 24 (53.3%) between 46-60 years age group. Based on the World Health Organization (WHO) classification of hearing loss, 27 patients had mild sensorineural hearing loss, 12 patients with moderate, and 6 patients with moderately severe sensorineural hearing loss. Conclusion: SNHL were found among patients who had COVID-19 infection, but due to the absence of a pre COVID-19 documented audiogram, it was difficult to conclude whether the hearing loss had occurred due to COVID-19, pre-existing hearing loss, or age-related. Further studies are required for proper understanding and correlation.

Tele Otology in India: Last 10 Years-A Scopic Review.

Hearing loss is the commonest sensory deficit among humans, affecting 466 million people worldwide. Early detection is the key to hearing rehabilitation, as speech and language develops early in the childhood. Scarcity of human resources and infrastructure in developing countries like India leads to difficulty in implementation of hearing screening programmes. Tele otology is very fruitful methodology in providing health care facility from distant site to the doorsteps of needy individuals. The action initiated in the field of tele otology in India was reviewed at electronic databases: Pubmed, Google scholar, Medline, Cochrane library, science direct and author mapper using the keywords 'tele otology' and 'tele audiometry' in January 2021. Eligible studies were those related to tele otology and tele audiometry in India. A total of 16 articles were shortlisted for the present study. Tele hearing testing was satisfactory for the parents in regard to accessibility, testing process and counselling. Tele audiometry surveillance shows better overall follow-up compliance rate then in-person audiological surveillance. During covid 19 pandemic virtual approach to the patient through video calling and telephone calls proved handy approach, ensuring safety profile of both health care professionals and patients. Even Tele ABR conducted in tele van shows similar results as in face-to-face mode ABR. Tele otology should be considered by the service providers and policy makers while planning for hearing screening programmes for both new-born and school going children in view of its reliability, low-cost, non-invasive and portability. The village health workers (VHWs) should be well trained in assisting tele practice and internet connectivity should be well established. Tele otology looks very promising in providing health services through the ever-expanding reach of global connectivity.

The Quality of Online Education for Theoretical Courses of Audiology from the Perspective of Audiology Students at Tehran University of Medical Sciences during the COVID-19 Pandemic

Background and Aim: The face-to-face education was suspended during the COVID-19 pandemic. In such situations, online education method was used. In this study, we aim to assess the quality of online education for theoretical courses of audiology from the perspective of audiology students at Tehran University of Medical Sciences (TUMS) during the COVID-19 pandemic. Methods: This comparative cross-sectional study was conducted on 77 audiology students of the School of Rehabilitation at TUMS. Data collection were a demographic form and two quality and satisfaction assessment questionnaires. Statistical analysis was performed in SPSS version 17. Results: There was a significant difference in all subscales of Shourcheh questionnaire among students with different educational stages (p<0.05), but there was no significant difference between age (except for social solidarity component) and gender (p>0.05) groups. The results of Kruskal-Wallis test showed a statistically significant difference in the quality scores among students with different educational stages (p=0.033), but there was no significant difference between age (p=0.300) and gender (p=0.630) groups. Conclusion: The quality of online education for theoretical courses of audiology at TUMS is high from the perspective of PhD students, while it is low according to BSc and MSc students. © 2023 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.

Bridging the Access Gap: The Telepractice Experience of Speech Therapists and Audiologists at a Public Health Care Facility in South Africa

South Africa is a low to middle income country (LMIC) with a population of 60 million people. The public health sector serves more than 80% of the population. Chris Hani Baragwanath Academic Hospital is a central level public health care facility situated in Gauteng. The Speech Therapy and Audiology Department provides insight into their telepractice services through a qualitative approach. The onset of the COVID-19 pandemic resulted in therapists exploring telepractice as a sustainable model of service delivery. Therapists and patients encountered many challenges to the implementation of telepractice, however, the commitment of therapists ensured that creative solutions were developed. A comprehensive needs analysis at public health institutions is required to ensure the sustainability of telepractice. A hybrid model (telepractice and in-person consults) holds the potential to reduce the financial burden on patients and increase access to quality patient-centered care.

The Consideration of Tele-Audiology Service Delivery in Korea

The importance of tele-audiology service delivery and accessibility has highlighted with the COVID-19 pandemic. Tele-audiology is an alternative method delivering various hearing intervention services including counselling, evaluation, fitting, and rehabilitation through telecommunication. The essential goal of tele-audiology service delivery is to obtain the best hearing rehabilitation outcomes equivalent to face-to-face service. Even though it has several advantages in aspects of service accessibility and effectiveness, convenience, and cost, still there are many challenges faced by audiologists, clients and administrators in order to implement tele-services in Korea. The present brief communication seeks to raise awareness in preparing and delivering the tele-audiology services with several considerations and challenges. We also focus on professional liability and training, service environment and information technology, and establishment of social system underling the tele-audiology service delivery in Korea. Copyright © 2022 Korean Academy of Audiology.

The impact of COVID-19 on speech–language and hearing professions in low-and middle-income countries: Challenges and opportunities explored

Background: Since the advent of the coronavirus disease 2019 (COVID-19), the speech– language and hearing (SLH) professions globally have been confronted with novel and unexpected challenges. Objective: The aim of this article was to explore the impact of COVID-19 on SLH professions in low-and middle-income countries (LMICs) as presented in the Special Issue of the South African Journal of Communication Disorders in the year 2022. Method: Divergent from the standard editorial writing style, this editorial adopted a research approach where a qualitative, descriptive scoping review design was conducted to meet the objectives of the study. Three specific objectives were targeted: (1) exploring the challenges to SLH research, teaching and practice;(2) establishing evidence-based solutions available for these challenges that can be used to improve the professions’ response in the post-pandemic era;and (3) determining the areas that require further investigation, alternative solutions and innovation for improved readiness for future pandemics. A total of 21 manuscripts were reviewed that covered three predetermined themes – research, teaching and practice – that were constructed through a deductive approach as part of the call for papers for the special issue. These manuscripts were from academics, researchers and clinicians from various institutions in LMICs. The review is presented using thematic analysis. Results: The review raised important challenges, presented under various subthemes, to the three key themes. These challenges reflect on the impact of COVID-19 on the SLH professions in terms of research, teaching, service provision and ethical challenges, as well as its impact on speech language, hearing, swallowing and balance functions. The review also advanced solutions and future directions during and beyond COVID-19. Conclusion: These findings raise global implications for research, teaching and practice that are not only relevant to the SLH professions. © 2022. The Authors. Licensee: AOSIS.

Speech Recognition and Listening Effort of Meaningful Sentences Using Synthetic Speech.

Speech-recognition tests are an important component of audiology. However, the development of such tests can be time consuming. The aim of this study was to investigate whether a Text-To-Speech (TTS) system can reduce the cost of development, and whether comparable results can be achieved in terms of speech recognition and listening effort. For this, the everyday sentences of the German Göttingen sentence test were synthesized for both a female and a male speaker using a TTS system. In a preliminary study, this system was rated as good, but worse than the natural reference. Due to the Covid-19 pandemic, the measurements took place online. Each set of speech material was presented at three fixed signal-to-noise ratios. The participants' responses were recorded and analyzed offline. Compared to the natural speech, the adjusted psychometric functions for the synthetic speech, independent of the speaker, resulted in an improvement of the speech-recognition threshold (SRT) by approximately 1.2 dB. The slopes, which were independent of the speaker, were about 15 percentage points per dB. The time periods between the end of the stimulus presentation and the beginning of the verbal response (verbal response time) were comparable for all speakers, suggesting no difference in listening effort. The SRT values obtained in the online measurement for the natural speech were comparable to published data. In summary, the time and effort for the development of speech-recognition tests may be significantly reduced by using a TTS system. This finding provides the opportunity to develop new speech tests with a large amount of speech material.