Development of the Children's English and Spanish Speech Recognition Test: Psychometric Properties, Feasibility, Reliability, and Normative Data.

OBJECTIVES: The Children's English and Spanish Speech Recognition (ChEgSS) test is a computer-based tool for assessing closed-set word recognition in English and in Spanish, with a masker that is either speech-shaped noise or competing speech. The present study was conducted to (1) characterize the psychometric properties of the ChEgSS test, (2) evaluate feasibility and reliability for a large cohort of Spanish/English bilingual children with normal hearing, and (3) establish normative data. DESIGN: Three experiments were conducted to evaluate speech perception in children (4-17 years) and adults (19-40 years) with normal hearing using the ChEgSS test. In Experiment 1, data were collected from Spanish/English bilingual and English monolingual adults at multiple, fixed signal-to-noise ratios. Psychometric functions were fitted to the word-level data to characterize variability across target words in each language and in each masker condition. In Experiment 2, Spanish/English bilingual adults were tested using an adaptive tracking procedure to evaluate the influence of different target-word normalization approaches on the reliability of estimates of masked-speech recognition thresholds corresponding to 70.7% correct word recognition and to determine the optimal number of reversals needed to obtain reliable estimates. In Experiment 3, Spanish/English bilingual and English monolingual children completed speech perception testing using the ChEgSS test to (1) characterize feasibility across age and language group, (2) evaluate test-retest reliability, and (3) establish normative data. RESULTS: Experiments 1 and 2 yielded data that are essential for stimulus normalization, optimizing threshold estimation procedures, and interpreting threshold data across test language and masker type. Findings obtained from Spanish/English bilingual and English monolingual children with normal hearing in Experiment 3 support feasibility and demonstrate reliability for use with children as young as 4 years of age. Equivalent results for testing in English and Spanish were observed for Spanish/English bilingual children, contingent on adequate proficiency in the target language. Regression-based threshold norms were established for Spanish/English bilingual and English monolingual children between 4 and 17 years of age. CONCLUSIONS: The present findings indicate the ChEgSS test is appropriate for testing a wide age range of children with normal hearing in either Spanish, English, or both languages. The ChEgSS test is currently being evaluated in a large cohort of patients with hearing loss at pediatric audiology clinics across the United States. Results will be compared with normative data established in the present study and with established clinical measures used to evaluate English- and Spanish-speaking children. Questionnaire data from parents and clinician feedback will be used to further improve test procedures.

Predicting speech-in-speech recognition: Short-term audibility and spatial separation.

Quantifying the factors that predict variability in speech-in-speech recognition represents a fundamental challenge in auditory science. Stimulus factors associated with energetic and informational masking (IM) modulate variability in speech-in-speech recognition, but energetic effects can be difficult to estimate in spectro-temporally dynamic speech maskers. The current experiment characterized the effects of short-term audibility and differences in target and masker location (or perceived location) on the horizontal plane for sentence recognition in two-talker speech. Thirty young adults with normal hearing (NH) participated. Speech reception thresholds and keyword recognition at a fixed signal-to-noise ratio (SNR) were measured in each spatial condition. Short-term audibility for each keyword was quantified using a glimpsing model. Results revealed that speech-in-speech recognition depended on the proportion of audible glimpses available in the target + masker keyword stimulus in each spatial condition, even across stimuli presented at a fixed global SNR. Short-term audibility requirements were greater for colocated than spatially separated speech-in-speech recognition, and keyword recognition improved more rapidly as a function of increases in target audibility with spatial separation. Results indicate that spatial cues enhance glimpsing efficiency in competing speech for young adults with NH and provide a quantitative framework for estimating IM for speech-in-speech recognition in different spatial configurations.

Building on the Academic Legacy of Pat Stelmachowicz and other Pioneers in Developmental Psychoacoustics and Pediatric Audiology: The Children's English/Spanish Speech Recognition Test (ChEgSS).

Basic research investigating auditory development often has implications for clinical diagnosis and treatment of hearing loss in children, but it can be challenging to translate those findings into practice. Meeting that challenge was a guiding principle of Pat Stelmachowicz's research and mentorship. Her example inspired many of us to pursue translational research and motivated the recent development of the Children's English/Spanish Speech Recognition Test (ChEgSS). This test evaluates word recognition in noise or two-talker speech, with target and masker speech produced in either English or Spanish. The test uses recorded materials and a forced-choice response, so the tester need not be fluent in the test language. ChEgSS provides a clinical measure of masked speech recognition outcomes for children who speak English, Spanish, or both, including estimates of performance in noise and two-talker speech, with the goal of maximizing speech and hearing outcomes for children with hearing loss. This article highlights several of Pat's many contributions to pediatric hearing research and describes the motivation and development of ChEgSS.

Predicting speech-in-speech recognition: Short-term audibility, talker sex, and listener factors.

Speech-in-speech recognition can be challenging, and listeners vary considerably in their ability to accomplish this complex auditory-cognitive task. Variability in performance can be related to intrinsic listener factors as well as stimulus factors associated with energetic and informational masking. The current experiments characterized the effects of short-term audibility of the target, differences in target and masker talker sex, and intrinsic listener variables on sentence recognition in two-talker speech and speech-shaped noise. Participants were young adults with normal hearing. Each condition included the adaptive measurement of speech reception thresholds, followed by testing at a fixed signal-to-noise ratio (SNR). Short-term audibility for each keyword was quantified using a computational glimpsing model for target+masker mixtures. Scores on a psychophysical task of auditory stream segregation predicted speech recognition, with stronger effects for speech-in-speech than speech-in-noise. Both speech-in-speech and speech-in-noise recognition depended on the proportion of audible glimpses available in the target+masker mixture, even across stimuli presented at the same global SNR. Short-term audibility requirements varied systematically across stimuli, providing an estimate of the greater informational masking for speech-in-speech than speech-in-noise recognition and quantifying informational masking for matched and mismatched talker sex.

Can Closed-Set Word Recognition Differentially Assess Vowel and Consonant Perception for School-Age Children With and Without Hearing Loss?

PURPOSE: Vowels and consonants play different roles in language acquisition and speech recognition, yet standard clinical tests do not assess vowel and consonant perception separately. As a result, opportunities for targeted intervention may be lost. This study evaluated closed-set word recognition tests designed to rely predominantly on either vowel or consonant perception and compared results with sentence recognition scores. METHOD: Participants were children (5-17 years of age) and adults (18-38 years of age) with normal hearing and children with sensorineural hearing loss (7-17 years of age). Speech reception thresholds (SRTs) were measured in speech-shaped noise. Children with hearing loss were tested with their hearing aids. Word recognition was evaluated using a three-alternative forced-choice procedure, with a picture-pointing response; monosyllabic target words varied with respect to either consonant or vowel content. Sentence recognition was evaluated for low- and high-probability sentences. In a subset of conditions, stimuli were low-pass filtered to simulate a steeply sloping hearing loss in participants with normal hearing. RESULTS: Children's SRTs improved with increasing age for words and sentences. Low-pass filtering had a larger effect for consonant-variable words than vowel-variable words for both children and adults with normal hearing, consistent with the greater high-frequency content of consonants. Children with hearing loss tested with hearing aids tended to perform more poorly than age-matched children with normal hearing, particularly for sentence recognition, but consonant- and vowel-variable word recognition did not appear to be differentially affected by the amount of high- and low-frequency hearing loss. CONCLUSIONS: Closed-set recognition of consonant- and vowel-variable words appeared to differentially evaluate vowel and consonant perception but did not vary by configuration of hearing loss in this group of pediatric hearing aid users. Word scores obtained in this manner do not fully characterize the auditory abilities necessary for open-set sentence recognition, but they do provide a general estimate.

Masked-Speech Recognition for Linguistically Diverse Populations: A Focused Review and Suggestions for the Future.

PURPOSE: Twenty years ago, von Hapsburg and Peña (2002) wrote a tutorial that reviewed the literature on speech audiometry and bilingualism and outlined valuable recommendations to increase the rigor of the evidence base. This review article returns to that seminal tutorial to reflect on how that advice was applied over the last 20 years and to provide updated recommendations for future inquiry. METHOD: We conducted a focused review of the literature on masked-speech recognition for bilingual children and adults. First, we evaluated how studies published since 2002 described bilingual participants. Second, we reviewed the literature on native language masked-speech recognition. Third, we discussed theoretically motivated experimental work. Fourth, we outlined how recent research in bilingual speech recognition can be used to improve clinical practice. RESULTS: Research conducted since 2002 commonly describes bilingual samples in terms of their language status, competency, and history. Bilingualism was not consistently associated with poor masked-speech recognition. For example, bilinguals who were exposed to English prior to age 7 years and who were dominant in English performed comparably to monolinguals for masked-sentence recognition tasks. To the best of our knowledge, there are no data to document the masked-speech recognition ability of these bilinguals in their other language compared to a second monolingual group, which is an important next step. Nonetheless, individual factors that commonly vary within bilingual populations were associated with masked-speech recognition and included language dominance, competency, and age of acquisition. We identified methodological issues in sampling strategies that could, in part, be responsible for inconsistent findings between studies. For instance, disparities in socioeconomic status (SES) between recruited bilingual and monolingual groups could cause confounding bias within the research design. CONCLUSIONS: Dimensions of the bilingual linguistic profile should be considered in clinical practice to inform counseling and (re)habilitation strategies since susceptibility to masking is elevated in at least one language for most bilinguals. Future research should continue to report language status, competency, and history but should also report language stability and demand for use data. In addition, potential confounds (e.g., SES, educational attainment) when making group comparisons between monolinguals and bilinguals must be considered.

Effects of word familiarity and receptive vocabulary size on speech-in-noise recognition among young adults with normal hearing.

Having a large receptive vocabulary benefits speech-in-noise recognition for young children, though this is not always the case for older children or adults. These observations could indicate that effects of receptive vocabulary size on speech-in-noise recognition differ depending on familiarity of the target words, with effects observed only for more recently acquired and less frequent words. Two experiments were conducted to evaluate effects of vocabulary size on open-set speech-in-noise recognition for adults with normal hearing. Targets were words acquired at 4, 9, 12 and 15 years of age, and they were presented at signal-to-noise ratios (SNRs) of -5 and -7 dB. Percent correct scores tended to fall with increasing age of acquisition (AoA), with the caveat that performance at -7 dB SNR was better for words acquired at 9 years of age than earlier- or later-acquired words. Similar results were obtained whether the AoA of the target words was blocked or mixed across trials. Differences in word duration appear to account for nonmonotonic effects of AoA. For all conditions, a positive correlation was observed between recognition and vocabulary size irrespective of target word AoA, indicating that effects of vocabulary size are not limited to recently acquired words. This dataset does not support differential assessment of AoA, lexical frequency, and other stimulus features known to affect lexical access.

Online Simulation Education for Audiometry Training.

PURPOSE: The purpose of this clinical focus article was to describe a new online simulation program for pure-tone audiometry. METHOD: Fictional but realistic patient profiles and testing environments were created to teach students about hearing screening protocols and pure-tone audiology. The diversity of the demographics of the United States is represented throughout the program. The web app was created using HTML/JS/CSS with a Flask server backend and MySQL database. RESULTS: The program allows students to learn the process of conducting a hearing screening and measuring audiometric thresholds using a web-based virtual clinical audiometer. The virtual audiometer includes standard audiometer features and allows for instruction based on standard guidelines. The diversity of the patients within the simulation program allows for discussions of diversity to be woven throughout the curriculum. CONCLUSIONS: The new simulation program is designed for use as a clinical training tool enabling undergraduate and graduate students to actively participate in hearing screening testing and pure-tone audiometry using any web browser. The program is also designed with the intent to improve pedagogical outcomes at the undergraduate and graduate level for communication sciences and disorders education for pure-tone audiometry by providing instructors with content that focuses on the diversity that is represented in the demographics of the United States.

A Simplified Approach to Quantifying a Child's Bilingual Language Experience.

Purpose Bilingual children's linguistic experience can vary markedly from child to child. For appropriate audiological assessment and intervention, audiologists need accurate and efficient ways to describe and understand a bilingual child's dynamic linguistic experience. This report documents an approach for quantitatively capturing a child's language exposure and usage in a time-efficient manner. Method A well-known pediatric bilingual language survey was administered to 83 parents of bilingual children, obtaining information about the child's exposure to (input) and usage of (output) Spanish and English for seventeen 1-hr intervals during a typical weekday and weekend day. Results A factor analysis indicated that capturing linguistic exposure and usage over three grouped-time intervals during a typical weekday and weekend day accounted for ≥ 74% of the total variance of the linguistic information captured with the full-length survey. Conclusions Although further confirmation is required, these results suggest that collecting language exposure and usage data from parents of bilingual children for three grouped-time intervals provides similar information as a comprehensive hour-by-hour approach. A time-efficient method of capturing the dynamic bilingual linguistic experience of a child would benefit pediatric audiologists and speech-language pathologists alike.

Does Sentence-Level Coarticulation Affect Speech Recognition in Noise or a Speech Masker?

Purpose Three experiments were conducted to better understand the role of between-word coarticulation in masked speech recognition. Specifically, we explored whether naturally coarticulated sentences supported better masked speech recognition as compared to sentences derived from individually spoken concatenated words. We hypothesized that sentence recognition thresholds (SRTs) would be similar for coarticulated and concatenated sentences in a noise masker but would be better for coarticulated sentences in a speech masker. Method Sixty young adults participated (n = 20 per experiment). An adaptive tracking procedure was used to estimate SRTs in the presence of noise or two-talker speech maskers. Targets in Experiments 1 and 2 were matrix-style sentences, while targets in Experiment 3 were semantically meaningful sentences. All experiments included coarticulated and concatenated targets; Experiments 2 and 3 included a third target type, concatenated keyword-intensity-matched (KIM) sentences, in which the words were concatenated but individually scaled to replicate the intensity contours of the coarticulated sentences. Results Regression analyses evaluated the main effects of target type, masker type, and their interaction. Across all three experiments, effects of target type were small (< 2 dB). In Experiment 1, SRTs were slightly poorer for coarticulated than concatenated sentences. In Experiment 2, coarticulation facilitated speech recognition compared to the concatenated KIM condition. When listeners had access to semantic context (Experiment 3), a coarticulation benefit was observed in noise but not in the speech masker. Conclusions Overall, differences between SRTs for sentences with and without between-word coarticulation were small. Beneficial effects of coarticulation were only observed relative to the concatenated KIM targets; for unscaled concatenated targets, it appeared that consistent audibility across the sentence offsets any benefit of coarticulation. Contrary to our hypothesis, effects of coarticulation generally were not more pronounced in speech maskers than in noise maskers.

Spoken narrative comprehension for young adult listeners: effects of competing voices and noise.

OBJECTIVE: To examine the influence of competing voices or noise on the comprehension of spoken narratives for young adults. DESIGN: First, an intelligibility assessment of the target narratives was conducted to establish a signal-to-noise ratio ensuring accurate initial speech recognition. Then, narrative comprehension for two target types (fixed and varied target talker) was measured in four listening conditions (quiet, one-talker speech, speech babble, speech-shaped noise). After hearing target narratives in each listening condition, participants completed a visual recognition memory task that assessed the comprehension of the narrative materials at three levels of representation (surface form, propositional, event model). STUDY SAMPLE: Seventy adults (18-32 years of age). RESULTS: Narrative comprehension results revealed a main effect of listening condition at the event model level, indicating poorer narrative memory of described situations for all noise conditions compared to quiet. Increased positive responses to thematically consistent but situationally "wrong" memory probes drove this effect. No other significant effects were observed. CONCLUSION: Despite near-perfect speech recognition, background noise negatively influenced aspects of spoken narrative comprehension and memory. Specifically, noise did not disrupt memory for what was said (surface form and propositional memory), but only memory for what was talked about (event model memory).

Contribution of Stimulus Variability to Word Recognition in Noise Versus Two-Talker Speech for School-Age Children and Adults.

BACKGROUND: Speech-in-speech recognition scores tend to be more variable than the speech-in-noise recognition scores, both within and across listeners. This variability could be due to listener factors, such as individual differences in audibility or susceptibility to informational masking. It could also be due to stimulus variability, with some speech-in-speech samples posing more of a challenge than others. The purpose of this experiment was to test two hypotheses: (1) that stimulus variability affects adults' word recognition in a two-talker speech masker and (2) that stimulus variability plays a smaller role in children's performance due to relatively greater contributions of listener factors. METHODS: Listeners were children (5 to 10 years) and adults (18 to 41 years) with normal hearing. Target speech was a corpus of 30 disyllabic words, each associated with an unambiguous illustration. Maskers were 30 samples of either two-talker speech or speech-shaped noise. The task was a four-alternative forced choice. Speech reception thresholds were measured adaptively, and those results were used to determine the signal-to-noise ratio associated with ≈65% correct for each listener and masker. Two 30-word blocks of fixed-level testing were then completed in each of the two conditions: (1) with the target-masker pairs randomly assigned prior to each block and (2) with frozen target-masker pairs. RESULTS: Speech reception thresholds were lower for adults than for children, particularly for the two-talker speech masker. Listener responses in fixed-level testing were evaluated for consistency across listeners. Target sample was the best predictor of performance in the speech-shaped noise masker for both the random and frozen conditions. In contrast, both the target and masker samples affected performance in the two-talker masker. Results were qualitatively similar for children and adults, and the pattern of performance across stimulus samples was consistent, with differences in masked target audibility in both age groups. CONCLUSIONS: Although word recognition in speech-shaped noise differed consistently across target words, recognition in a two-talker speech masker depended on both the target and masker samples. These stimulus effects are broadly consistent with a simple model of masked target audibility. Although variability in speech-in-speech recognition is often thought to reflect differences in informational masking, the present results suggest that variability in energetic masking across stimuli can play an important role in performance.

The effect of fundamental frequency contour similarity on multi-talker listening in older and younger adults.

Older adults with hearing loss have greater difficulty recognizing target speech in multi-talker environments than young adults with normal hearing, especially when target and masker speech streams are perceptually similar. A difference in fundamental frequency (f0) contour depth is an effective stream segregation cue for young adults with normal hearing. This study examined whether older adults with varying degrees of sensorineural hearing loss are able to utilize differences in target/masker f0 contour depth to improve speech recognition in multi-talker listening. Speech recognition thresholds (SRTs) were measured for speech mixtures composed of target/masker streams with flat, normal, and exaggerated speaking styles, in which f0 contour depth systematically varied. Computational modeling estimated differences in energetic masking across listening conditions. Young adults had lower SRTs than older adults; a result that was partially explained by differences in audibility predicted by the model. However, audibility differences did not explain why young adults experienced a benefit from mismatched target/masker f0 contour depth, while in most conditions, older adults did not. Reduced ability to use segregation cues (differences in target/masker f0 contour depth), and deficits grouping speech with variable f0 contours likely contribute to difficulties experienced by older adults in challenging acoustic environments.

The Clear-Speech Benefit for School-Age Children: Speech-in-Noise and Speech-in-Speech Recognition.

Purpose Talkers often modify their speech when communicating with individuals who struggle to understand speech, such as listeners with hearing loss. This study evaluated the benefit of clear speech in school-age children and adults with normal hearing for speech-in-noise and speech-in-speech recognition. Method Masked sentence recognition thresholds were estimated for school-age children and adults using an adaptive procedure. In Experiment 1, the target and masker were summed and presented over a loudspeaker located directly in front of the listener. The masker was either speech-shaped noise or two-talker speech, and target sentences were produced using a clear or conversational speaking style. In Experiment 2, stimuli were presented over headphones. The two-talker speech masker was diotic (M0). Clear and conversational target sentences were presented either in-phase (T0) or out-of-phase (Tπ) between the two ears. The M0Tπ condition introduces a segregation cue that was expected to improve performance. Results For speech presented over a single loudspeaker (Experiment 1), the clear-speech benefit was independent of age for the noise masker, but it increased with age for the two-talker masker. Similar age effects for the two-talker speech masker were seen under headphones with diotic presentation (M0T0), but comparable clear-speech benefit as a function of age was observed with a binaural cue to facilitate segregation (M0Tπ). Conclusions Consistent with prior research, children showed a robust clear-speech benefit for speech-in-noise recognition. Immaturity in the ability to segregate target from masker speech may limit young children's ability to benefit from clear-speech modifications for speech-in-speech recognition under some conditions. When provided with a cue that facilitates segregation, children as young as 4-7 years of age derived a clear-speech benefit in a two-talker masker that was similar to the benefit experienced by adults.

Masked English Speech Recognition Performance in Younger and Older Spanish-English Bilingual and English Monolingual Children.

Purpose The purpose of this study was to compare masked English speech recognition thresholds between Spanish-English bilingual and English monolingual children and to evaluate effects of age, maternal education, and English receptive language abilities on individual differences in masked speech recognition. Method Forty-three Spanish-English bilingual children and 42 English monolingual children completed an English sentence recognition task in 2 masker conditions: (a) speech-shaped noise and (b) 2-talker English speech. Two age groups of children, younger (5-6 years) and older (9-10 years), were tested. The predictors of masked speech recognition performance were evaluated using 2 mixed-effects regression models. In the 1st model, fixed effects were age group (younger children vs. older children), language group (bilingual vs. monolingual), and masker type (speech-shaped noise vs. 2-talker speech). In the 2nd model, the fixed effects of receptive English vocabulary scores and maternal education level were also included. Results Younger children performed more poorly than older children, but no significant difference in masked speech recognition was observed between bilingual and monolingual children for either age group when English proficiency and maternal education were also included in the model. English language abilities fell within age-appropriate norms for both groups, but individual children with larger receptive vocabularies in English tended to show better recognition; this effect was stronger for younger children than for older children. Speech reception thresholds for all children were lower in the speech-shaped noise masker than in the 2-talker speech masker. Conclusions Regardless of age, similar masked speech recognition was observed for Spanish-English bilingual and English monolingual children tested in this study when receptive English language abilities were accounted for. Receptive English vocabulary scores were associated with better masked speech recognition performance for both bilinguals and monolinguals, with a stronger relationship observed for younger children than older children. Further investigation involving a Spanish-dominant bilingual sample is warranted given the high English language proficiency of children included in this study.

Effects of Language History on Sentence Recognition in Noise or Two-Talker Speech: Monolingual, Early Bilingual, and Late Bilingual Speakers of English.

Purpose Language history is an important factor in masked speech recognition. Listeners who acquire the target language later in life perform more poorly than native speakers. However, there are inconsistencies in the literature regarding performance of bilingual speakers who begin learning the target language early in life. The purpose of this experiment was to evaluate speech-in-noise and speech-in-speech recognition for highly proficient early bilingual listeners compared to monolingual and late bilingual listeners. Method Three groups of young adults participated: native monolingual English speakers, bilingual Mandarin-English speakers who learned English from birth (early bilinguals), and native Mandarin speakers who learned English later in life (late bilinguals). All participants had normal hearing and were full-time college students. Recognition was assessed for English sentences in speech-shaped noise and two-talker English speech. Participants provided linguistic and demographic information, and late bilinguals completed the Versant test of spoken English abilities. Results All listeners performed better in speech-shaped noise than two-talker speech. Performance was similar for monolingual and early bilinguals. Late bilinguals performed more poorly overall. There was evidence for a stronger association between masked speech recognition and English dominance for late bilinguals compared to early bilinguals. Conclusion These results support the conclusion that bilingualism itself does not necessarily result in a disadvantage when recognizing masked speech in noise and speech in speech. For populations similar to those studied here (highly proficient early bilinguals), it would be appropriate to evaluate masked speech recognition using the same simple stimuli and normative data used for monolingual speakers of English.

The effect of target/masker fundamental frequency contour similarity on masked-speech recognition.

Greater informational masking is observed when the target and masker speech are more perceptually similar. Fundamental frequency (f0) contour, or the dynamic movement of f0, is thought to provide cues for segregating target speech presented in a speech masker. Most of the data demonstrating this effect have been collected using digitally modified stimuli. Less work has been done exploring the role of f0 contour for speech-in-speech recognition when all of the stimuli have been produced naturally. The goal of this project was to explore the importance of target and masker f0 contour similarity by manipulating the speaking style of talkers producing the target and masker speech streams. Sentence recognition thresholds were evaluated for target and masker speech that was produced with either flat, normal, or exaggerated speaking styles; performance was also measured in speech spectrum shaped noise and for conditions in which the stimuli were processed through an ideal-binary mask. Results confirmed that similarities in f0 contour depth elevated speech-in-speech recognition thresholds; however, when the target and masker had similar contour depths, targets with normal f0 contours were more resistant to masking than targets with flat or exaggerated contours. Differences in energetic masking across stimuli cannot account for these results.

Language Proficiency and Dominance Considerations When Working With Spanish-English Bilingual Adults.

Purpose As the Hispanic population continues to increase within the United States, there is a pressing need to incorporate rigorous and efficient clinical assessments of language dominance and proficiency when working with Spanish-English bilingual patients. The purpose of this study was to begin addressing this need by evaluating the association between language dominance and language proficiency. Method The association between scores for the English Versant Test (Pearson Education, 2010), an automated assessment of spoken language proficiency, and dominance and proficiency scores obtained using the Bilingual Language Profile, a self-report questionnaire was evaluated. Results The results indicated that half of the variance in the English Versant Test was explained by the response to a single question included in the Bilingual Language Profile. Conclusion These data support the inclusion of asking patients to not only indicate how many languages they speak but, for those patients that speak more than 1 language, to also ask how well they understand each of the languages.

Psychometric function slope for speech-in-noise and speech-in-speech: Effects of development and aging.

Masked sentence recognition was evaluated in normal-hearing children (8.8-10.5 years), young adults (18-28 years), and older adults (60-71 years). Consistent with published data, speech recognition thresholds were poorer for young children and older adults than for young adults, particularly when the masker was composed of speech. Psychometric function slopes were steeper for young children and older adults than for young adults when the masker was two-talker speech, but not when it was speech-shaped noise. Multiple factors are implicated in the age effects observed for speech-in-speech recognition at low signal-to-noise ratios.

Masked Sentence Recognition in Children, Young Adults, and Older Adults: Age-Dependent Effects of Semantic Context and Masker Type.

OBJECTIVES: Masked speech recognition in normal-hearing listeners depends in part on masker type and semantic context of the target. Children and older adults are more susceptible to masking than young adults, particularly when the masker is speech. Semantic context has been shown to facilitate noise-masked sentence recognition in all age groups, but it is not known whether age affects a listener's ability to use context with a speech masker. The purpose of the present study was to evaluate the effect of masker type and semantic context of the target as a function of listener age. DESIGN: Listeners were children (5 to 16 years), young adults (19 to 30 years), and older adults (67 to 81 years), all with normal or near-normal hearing. Maskers were either speech-shaped noise or two-talker speech, and targets were either semantically correct (high context) sentences or semantically anomalous (low context) sentences. RESULTS: As predicted, speech reception thresholds were lower for young adults than either children or older adults. Age effects were larger for the two-talker masker than the speech-shaped noise masker, and the effect of masker type was larger in children than older adults. Performance tended to be better for targets with high than low semantic context, but this benefit depended on age group and masker type. In contrast to adults, children benefitted less from context in the two-talker speech masker than the speech-shaped noise masker. Context effects were small compared with differences across age and masker type. CONCLUSIONS: Different effects of masker type and target context are observed at different points across the lifespan. While the two-talker masker is particularly challenging for children and older adults, the speech masker may limit the use of semantic context in children but not adults.