An Exploration of the Memory Performance in Older Adult Hearing Aid Users on the Integrated Digit-in-Noise Test.

This study aimed to preliminarily investigate the associations between performance on the integrated Digit-in-Noise Test (iDIN) and performance on measures of general cognition and working memory (WM). The study recruited 81 older adult hearing aid users between 60 and 95 years of age with bilateral moderate to severe hearing loss. The Chinese version of the Montreal Cognitive Assessment Basic (MoCA-BC) was used to screen older adults for mild cognitive impairment. Speech reception thresholds (SRTs) were measured using 2- to 5-digit sequences of the Mandarin iDIN. The differences in SRT between five-digit and two-digit sequences (SRT5-2), and between five-digit and three-digit sequences (SRT5-3), were used as indicators of memory performance. The results were compared to those from the Digit Span Test and Corsi Blocks Tapping Test, which evaluate WM and attention capacity. SRT5-2 and SRT5-3 demonstrated significant correlations with the three cognitive function tests (rs ranging from -.705 to -.528). Furthermore, SRT5-2 and SRT5-3 were significantly higher in participants who failed the MoCA-BC screening compared to those who passed. The findings show associations between performance on the iDIN and performance on memory tests. However, further validation and exploration are needed to fully establish its effectiveness and efficacy.

Development of the mandarin reading span test and confirmation of its relationship with speech perception in noise.

OBJECTIVE: This study aimed to develop a dual-task Mandarin Reading Span Test (RST) to assess verbal working memory related to speech perception in noise. DESIGN: The test material was developed taking into account psycholinguistic factors (i.e. sentence structure, number of syllables, word familiarity, and sentences plausibility), to achieve good test reliability and face validity. The relationship between the 28-sentence Mandarin RST and speech perception in noise was confirmed using three speech perception in noise measures containing varying levels of contextual and linguistic information. STUDY SAMPLE: The study comprised 42 young adults with normal hearing and 56 older adult who were hearing aid users with moderate to severe hearing loss. RESULTS: In older hearing aid users, the 28-sentence RST showed significant correlation with speech reception thresholds as measured by three Mandarin sentence in noise tests (rs or r = -.681 to -.419) but not with the 2-digit sequence Digit-in-Noise Test. CONCLUSION: The newly developed dual-task Mandarin RST, constructed with careful psycholinguistic consideration, demonstrates a significant relationship with sentence perception in noise. This suggests that the Mandarin RST could serve as a measure of verbal working memory.

Development of the Mandarin Digit-in-Noise Test and Examination of the Effect of the Number of Digits Used in the Test.

OBJECTIVES: The study aimed to develop and validate the Mandarin digit-in-noise (DIN) test using four digit (i.e., two-, three-, four-, and five-digit) sequences. Test-retest reliability and criterion validity were evaluated. How the number of digits affected the results was examined. The research might lead to more informed choice of DIN tests for populations with specific cognitive needs such as memory impairment. DESIGN: The International Collegium of Rehabilitative Audiology guideline for developing the DIN was adapted to create test materials. The test-retest reliability and psychometric function of each digit sequence were determined among young normal-hearing adults. The criterion validity of each digit sequence was determined by comparing the measured performance of older adult hearing aid users with that obtained from two other well-established sentence-in-noise tests: the Mandarin hearing-in-noise test and the Mandarin Chinese matrix test. The relation between the speech reception thresholds (SRTs) of each digit sequence of the DIN test and working memory capacity measured using the digit span test and the reading span test were explored among older adult hearing aid users. Together, the study sample consisted of 54 young normal-hearing adults and 56 older adult hearing aid users. RESULTS: The slopes associated with the two-, three-, four-, and five-digit DIN test were 16.58, 18.79, 20.42, and 21.09 %/dB, respectively, and the mean SRTs were -11.11, -10.99, -10.56, and -10.02 dB SNR, respectively. Test-retest SRTs did not differ by more than 0.74 dB across all digit sequences, suggesting good test-retest reliability. Spearman rank-order correlation coefficients between SRTs obtained using the DIN across the four digit (i.e., two-, three-, four-, and five-digit) sequences and the two sentence-in-noise tests were uniformly high ( rs = 0.9) across all participants, when data from all participants were considered. Results from the digit span test and reading span test correlated significantly with the results of the five-digit sequences ( rs = -0.37 and -0.42, respectively) but not with the results of the two-, three-, and four-digit sequences among older hearing aid users. CONCLUSIONS: While the three-digit sequence was found to be appropriate for clinical use for assessment of auditory perception, the two-digit sequence could be used for hearing screening. The five-digit sequence could be difficult for older hearing aid users, and with its SRT related to working memory capacity, its use in the evaluation of speech perception should be investigated further. The Mandarin DIN test was found to be reliable, and the findings are in line with SRTs obtained using standardized sentence tests, suggesting good criterion validity.

Discrimination of consonants in quiet and in noise in Mandarin-speaking children with normal hearing.

OBJECTIVE: Given the critical role of consonants in speech perception and the lack of knowledge on consonant perception in noise in Mandarin-speaking children, the current study aimed to investigate Mandarin consonant discrimination in normal-hearing children, in relation to the effects of age and signal-to-noise ratios (S/N). DESIGN: A discrimination task consisting of 33 minimal pairs in monosyllabic words was designed to explore the development of consonant discrimination in five test conditions: 0, -5, -10, -15 dB S/Ns, and quiet. STUDY SAMPLE: Forty Mandarin-speaking, normal-hearing children aged from 4;0 to 8;9 in one-year-age increment were recruited and their performance was compared to 10 adult listeners. RESULTS: A significant main effect of age, test conditions, and an interaction effect between these variables was noted. Consonant discrimination in quiet and in noise improved as children became older. Consonants that were difficult to discriminate in quiet and in noise were mainly velar contrasts. Noise seemed to have less effect on the discrimination of affricates and fricatives, and plosives appeared to be to be more difficult to discriminate in noise than in quiet. Place contrasts between alveolar and palato-alveolar consonants were difficult in quiet. CONCLUSIONS: The findings were the first to reveal typical perceptual development of Mandarin consonant discrimination in children and can serve as a reference for comparison with children with disordered perceptual development, such as those with hearing loss.

Barriers to hearing aid adoption among older adults in mainland China.

OBJECTIVE: This study aimed to explore barriers to hearing aid adoption amongst older adults in mainland China. DESIGN: Semi-structured interviews were audio-recorded and analysed using qualitative thematic analysis. STUDY SAMPLE: The study included 12 older adults who had seen ENTs and had not adopted hearing aids. RESULTS: Three overarching themes and ten subthemes were generated to explain why older adults in mainland China do not adopt hearing aids: (1) Desire a cure for hearing loss, (2) Lack of a perceived need for hearing aids, and (3) Negative impressions of, and misconceptions about, hearing aids. CONCLUSION: Although barriers are similar to those reported in Western societies, the under-developed hearing healthcare infrastructure, Chinese health beliefs, Chinese culture, and low health literacy play important roles in preventing older adults to adopt hearing aids in mainland China. To identify barriers to hearing aid adoption and address them, hearing health practitioners should learn what older adults know about their hearing loss, how they perceive the effects of hearing loss, and how they feel about hearing aids.

Pre-attentive fundamental frequency processing in Mandarin-speaking children with cochlear implants as revealed by the peak latency of positive mismatch response.

Introduction: Fundamental frequency (F0) serves as the primary acoustic cue for Mandarin tone perception. Recent behavioral studies suggest that F0 information may be differently processed between Mandarin-speaking normal-hearing (NH) children and children with cochlear implants (CIs), which may partially explain the unsatisfactory outcome of lexical tone recognition using CIs with tonal language-oriented speech processing strategies. The aim of the current study was to provide neural evidence of F0 processing in Mandarin-speaking kindergarten-aged children with CIs compared with NH children. Methods: Positive mismatch responses (p-MMRs) to the change of the two acoustic dimensions of F0 (F0 contour and F0 level) in Mandarin-speaking kindergarten-aged children with CIs (n = 19) and their age-matched NH peers (n = 21). Results: The two groups of children did not show any significant difference on the mean amplitude of p-MMR to either F0 contour or F0 level change. While the CI group exhibited a significantly shorter peak latency of p-MMR to F0 contour change than to F0 level change, an opposite pattern was observed in the NH group. Discussion: This study revealed a higher sensitivity to F0 contour change than to F0 level change in children with CIs, which was different from that in NH children. The neural evidence of discrepant F0 processing between children with CIs and NH children in this study was consistent with the previously reported behavioral findings and may serve as a reference for the development and improvement of tonal language-oriented speech processing strategies.

Development and evaluation of the Cantonese matrix sentence test.

OBJECTIVE: To develop the Cantonese matrix (YUEmatrix) test according to the international standard procedure and examine possible different outcomes in another tonal language. DESIGN: A 50-word Cantonese base-matrix was established. Word-specific speech recognition functions, speech recognition thresholds (SRT), and slopes were obtained. The speech material was homogenised in intelligibility by applying level corrections up to ± 3 dB. Subsequently, the YUEmatrix test was evaluated in five aspects: training effect, test-list equivalence, test-retest reliability, establishment of reference data for normal-hearing Cantonese-speakers, and comparison with the Cantonese-Hearing-In-Noise-Test. STUDY SAMPLE: Overall, 64 normal-hearing native Cantonese-speaking listeners. RESULTS: SRT measurements with adaptive procedures resulted in a reference SRT of -9.7 ± 0.7 dB SNR for open-set and -11.1 ± 1.2 dB SNR for the closed-set response format. Fixed SNR measurements suggested a test-specific speech intelligibility function slope of 15.5 ± 0.7%/dB. Seventeen 10-sentences base test lists were confirmed to be equivalent with respect to speech intelligibility. Training effect was not observed after two measurements of 20-sentences lists. CONCLUSIONS: The YUEmatrix yields comparable results to matrix tests in other languages including Mandarin. Level adjustments to homogenise sentences appear to be less effective for tonal languages than for most other languages developed so far.

Just-Noticeable Differences of Fundamental Frequency Change in Mandarin-Speaking Children with Cochlear Implants.

Fundamental frequency (F0) provides the primary acoustic cue for lexical tone perception in tonal languages but remains poorly represented in cochlear implant (CI) systems. Currently, there is still a lack of understanding of sensitivity to F0 change in CI users who speak tonal languages. In the present study, just-noticeable differences (JNDs) of F0 contour and F0 level changes in Mandarin-speaking children with CIs were measured and compared with those in their age-matched normal-hearing (NH) peers. Results showed that children with CIs demonstrated significantly larger JND of F0 contour (JND-C) change and F0 level (JND-L) change compared to NH children. Further within-group comparison revealed that the JND-C change was significantly smaller than the JND-L change among children with CIs, whereas the opposite pattern was observed among NH children. No significant correlations were seen between JND-C change/JND-L change and age at implantation /duration of CI use. The contrast between children with CIs and NH children in sensitivity to F0 contour and F0 level change suggests different mechanisms of F0 processing in these two groups as a result of different hearing experiences.

A Review of Speech Perception of Mandarin-Speaking Children With Cochlear Implantation.

Objective: This paper reviewed the literature on the development of and factors affecting speech perception of Mandarin-speaking children with cochlear implantation (CI). We also summarized speech outcome measures in standard Mandarin for evaluating auditory and speech perception of children with CI. Method: A comprehensive search of Google Scholar and PubMed was conducted from March to June 2021. Search terms used were speech perception/lexical tone recognition/auditory perception AND cochlear implant AND Mandarin/Chinese. Conclusion: Unilateral CI recipients demonstrated continuous improvements in auditory and speech perception for several years post-activation. Younger age at implantation and longer duration of CI use contribute to better speech perception. Having undergone a hearing aid trial before implantation and having caregivers whose educational level is higher may lead to better performance. While the findings that support the use of CI to improve speech perception continue to grow, much research is needed to validate the use of unilateral and bilateral implantation. Evidence to date, however, revealed bimodal benefits over CI-only conditions in lexical tone recognition and sentence perception in noise. Due to scarcity of research, conclusions on the benefits of bilateral CIs compared to unilateral CI or bimodal CI use cannot be drawn. Therefore, future research on bimodal and bilateral CIs is needed to guide evidence-based clinical practice.

Can Dual Compression Offer Better Mandarin Speech Intelligibility and Sound Quality Than Fast-Acting Compression?

The aim of this study was to evaluate the efficacy of dual compression for Mandarin-speaking hearing aid users. Dual compression combines fast and slow compressors operating simultaneously across all frequency channels. The study participants were 31 hearing aid users with symmetrical moderate-to-severe hearing loss, with a mean age of 67 years. A new pair of 20-channel behind-the-ear hearing aids (i.e., Phonak Bolero B90-P) was used during the testing. The results revealed a significant improvement in speech reception thresholds in noise when switching from fast-acting compression to dual compression. The sound quality ratings revealed that most listeners preferred dual compression to fast-acting compression for listening effort, listening comfort, speech clarity, and overall sound quality at +4 dB signal-to-noise ratio. These results are consistent with predictions based on the theoretical understanding of dual and fast-acting compression. However, whether these results can be generalized to other languages or other dual compression systems should be verified by future studies.

Speech Perception in Noise Is Associated With Different Cognitive Abilities in Chinese-Speaking Older Adults With and Without Hearing Aids.

Chinese-speaking older adults usually do not perceive a hearing problem until audiometric thresholds exceed 45 dB HL, and the audiometric thresholds of the average hearing-aid (HA) user often exceed 60 dB HL. The purpose of this study was to examine the relationships between cognitive and hearing functions (measured as audiometric or speech reception thresholds) in older Chinese adults with HAs and with untreated hearing loss (HL). Participants were 49 Chinese older adults who used HAs and had moderate to severe HL (HA group), and 46 older Chinese who had mild to moderately severe HL but did not use HAs (untreated; or UT group). Multiple linear regression analysis was employed to evaluate how well age, education level, audiometric thresholds, and speech perception in noise were related to performance on general cognitive function, working memory, executive function, attention, and verbal learning tests. Results showed that speech perception in noise alone accounted for 13-25% of the variance in general cognitive function, working memory, and executive function in the UT group, and 9-21% of the variance in general cognitive function and verbal learning in the HA group (i.e., medium effect sizes). Audiometric thresholds did not explain any proportion of the variance in cognitive functioning in the HA or UT group. Thus, speech perception in noise accounts for more variance in cognitive performance than audiometric thresholds, and is significantly associated with different cognitive functions in older Chinese adults with HAs and with untreated HL.

Effects of Fundamental Frequency Contours on Sentence Recognition in Mandarin-Speaking Children With Cochlear Implants.

Purpose Fundamental frequency (F0) is the primary acoustic cue for lexical tone perception in tonal languages but is processed in a limited way in cochlear implant (CI) systems. The aim of this study was to evaluate the importance of F0 contours in sentence recognition in Mandarin-speaking children with CIs and find out whether it is similar to/different from that in age-matched normal-hearing (NH) peers. Method Age-appropriate sentences, with F0 contours manipulated to be either natural or flattened, were randomly presented to preschool children with CIs and their age-matched peers with NH under three test conditions: in quiet, in white noise, and with competing sentences at 0 dB signal-to-noise ratio. Results The neutralization of F0 contours resulted in a significant reduction in sentence recognition. While this was seen only in noise conditions among NH children, it was observed throughout all test conditions among children with CIs. Moreover, the F0 contour-induced accuracy reduction ratios (i.e., the reduction in sentence recognition resulting from the neutralization of F0 contours compared to the normal F0 condition) were significantly greater in children with CIs than in NH children in all test conditions. Conclusions F0 contours play a major role in sentence recognition in both quiet and noise among pediatric implantees, and the contribution of the F0 contour is even more salient than that in age-matched NH children. These results also suggest that there may be differences between children with CIs and NH children in how F0 contours are processed.

Natural Language Input: Maternal Education, Socioeconomic Deprivation, and Language Outcomes in Typically Developing Children.

Purpose The current study was designed to investigate the differences in language input related to family factors (maternal level of education [MLE] and socioeconomic level of deprivation [SLD]) and their association with language outcomes in preschoolers. Method This study used New Zealand SLD and MLE classification systems to examine differences in language input related to these factors among 20 typically developing preschool children aged 2-5 years. The quantity of children's language input (adult words [AWs], conversational turns [CTs]) was calculated using the Language ENvironment Analysis audiotaping technology for two typical weekend days. Four 5-min Language ENvironment Analysis recording segments were transcribed and coded, and parental language strategies were classified as optimal language strategy, moderate language strategy, or sub-optimal language strategy (S-OLS) for child language outcomes. The receptive and expressive language of each child was assessed using the Preschool Language Scales-Fifth Edition. Results Mann-Whitney U tests showed significant differences between the quantity of language input (AWs/hr, CTs/hr) for high and low MLE and high and low SLD groups. Consistent with the literature, the use of S-OLSs was significantly lower for families with high MLE (Mdn = .25, IQR = .14) and low SLD (Mdn = .22, IQR = .13) than for families with low MLE (Mdn = .41, IQR = .24) and high SLD (Mdn = .41, IQR = .26). Spearman correlation coefficients indicated significant associations between language input (AWs/hr, CTs/hr, S-OLSs) and language outcomes. Conclusions Reduced language input and the frequent use of S-OLSs associated with low maternal education and high deprivation and low language outcomes for these children highlight the importance for all parents/families to learn optimal language strategies to support the development of strong language skills in their children in young age.

Visual mismatch negativity elicited by semantic violations in visual words.

The remarkable rapidity and effortlessness of speech perception and word reading by skilled listeners or readers suggest implicit or automatic mechanisms underlying language processing. In speech perception, the implicit mechanisms are reflected by the auditory mismatch negativity (MMN) response, suggesting that phonemic, lexical, semantic, and syntactic information are automatically and rapidly processed in the absence of focused attention. In visual word reading, implicit orthographic and lexical processing are reflected by visual mismatch negativity (vMMN), the visual counterpart of auditory MMN. The semantic processing of spoken words is reflected by MMN. This study investigated whether semantic processing is also reflected by vMMN. For this purpose, visual Chinese words belonging to different semantic categories (color, taste, and action) were presented to participants in oddball paradigms. A set of words belonging to the same semantic category was frequently presented as standards; a word belonging to a different semantic category was presented sporadically as deviant. Participants were instructed to perform a visual cross-change detection task and ignore the words. Significant vMMN was elicited in Experiments 1 to 3, in which the deviant word carried a semantic radical that overtly indicated the word's semantic category information. The vMMNs were most prominent around 260 ms after word onset, were parieto-occipital distributed, and were significantly left-hemisphere lateralized, suggesting rapid semantic processing of the visual words' category-related information. No significant vMMN was elicited in Experiment 4, in which the deviant word did not carry any semantic radicals. Thus, the semantic radical, which has a high frequency of occurrence because it is carried by many words, may be critical for the elicitation of vMMN.

Development of the mandarin hearing in noise test for children.

Objectives: To develop a Mandarin version of the Hearing in Noise Test for Children (MHINT-C) and examine the maturational effects on sentence recognition.Design: Sentences suitable for evaluating children aged 6-18 years were selected from the adult MHINT to form 12 lists of 10 MHINT-C sentences (Study 1). List equivalence, inter-list reliability, response variability, and maturational effects on sentence recognition were examined using the MHINT-C (Study 2).Study sample: A total of 246 children aged 6.1-17.11 years were included. Six children participated in Study 1; the rest were included in Study 2. To compare these results with adults, 20 native Mandarin-speaking adults aged 18 or above were included in Study 2.Results: MHINT-C list equivalency, inter-list reliability, and response variability were similar to those of the adult MHINT and the Cantonese HINT for children. Sentence recognition in children reached adult-like performance around age 8 in quiet and at ages 15 and 14 in front and side noise conditions, respectively.Conclusions: The MHINT-C can reliably measure sentence recognition in quiet and noise in Mandarin-speaking children. Age-specific correction factors were established.

Dataset on the calculations of daily adult word and conversational turn counts, and use of styles of oral interaction in 2-5-year olds with hearing loss in New Zealand.

This article describes the data regarding the calculations of language input from the natural language environments of children with hearing loss, taken from four full typical days in a week using a LENA (Language ENvironment Analysis) digital recorder. Calculations were based on 14 children with hearing loss from 24 to 60 months as they interacted with their family. Participants were recruited from the Hearing House, the Speech Clinic at the University of Auckland, and Early Childcare Centers (ECC) in Auckland, New Zealand. All families were interacting with their children orally without using sign language. Data were collected from natural language environments from May 2018 to May 2019. Language environments were examined in terms of daily quantity of language input and styles of oral interaction children were exposed to when interacting with their parent/primary caregiver. To determine quantity of language input, two kinds of observations were taken from the LENA automatic calculation of the number of adult words and number of conversational turns. Segments of the recordings were manually transcribed and coded onto 17 styles of oral interaction, which were further classified into three categories (optimal, moderate, and sub-optimal).

The Role of Lexical Tone Information in the Recognition of Mandarin Sentences in Listeners With Hearing Aids.

OBJECTIVES: Lexical tone information provides redundant cues for the recognition of Mandarin sentences in listeners with normal hearing in quiet conditions. The contribution of lexical tones to Mandarin sentence recognition in listeners with hearing aids (HAs) is unclear. This study aimed to remove lexical tone information and examine the effects on Mandarin sentence intelligibility in HA users. The second objective was to investigate the contribution of cognitive abilities (i.e., general cognitive ability, working memory, and attention) on Mandarin sentence perception when the presentation of lexical tone information was mismatched. DESIGN: A text-to-speech synthesis engine was used to manipulate Mandarin sentences into three test conditions: (1) a Normal Tone test condition, where no alterations were made to lexical tones within sentences; (2) a Flat Tone test condition, where lexical tones were all changed into tone 1 (i.e., the flat tone); and (3) a Random Tone test condition, where each word in test sentences was randomly assigned one of four Mandarin lexical tones. The manipulated sentence signals were presented to 32 listeners with HAs in both quiet and noisy environments at an 8 dB signal to noise ratio. RESULTS: Speech intelligibility was reduced significantly (by approximately 40 percentage points) in the presence of mismatched lexical tone information in both quiet and noise. The difficulty in correctly identifying sentences with mismatched lexical tones among adults with hearing loss was significantly greater than that of adults with normal hearing. Cognitive function was not significantly related to a decline in speech recognition scores. CONCLUSIONS: Contextual and other phonemic cues (i.e., consonants and vowels) are inadequate for HA users to perceive sentences with mismatched lexical tone contours in quiet or noise. Also, HA users with better cognitive function could not compensate for the loss of lexical tone information. These results highlight the importance of accurately representing lexical tone information for Mandarin speakers using HAs.

Analysis of Amount and Style of Oral Interaction Related to Language Outcomes in Children With Hearing Loss: A Systematic Review (2006-2016).

Purpose This systematic review summarizes the evidence for differences in the amount of language input between children with and without hearing loss (HL). Of interest to this review is evaluating the associations between language input and language outcomes (receptive and expressive) in children with HL in order to enhance insight regarding what oral language input is associated with good communication outcomes. Method A systematic review was conducted using keywords in 3 electronic databases: Scopus, PubMed, and Google Scholar. Keywords were related to language input, language outcomes, and HL. Titles and abstracts were screened independently, and full-text manuscripts meeting inclusion criteria were extracted. An appraisal checklist was used to evaluate the methodological quality of studies as poor, good, or excellent. Results After removing duplicates, 1,545 study results were extracted, with 27 eligible for full-text review. After the appraisal, 8 studies were included in this systematic review. Differences in the amount of language input between children with and without HL were noted. Conversational exchanges, open-ended questions, expansions, recast, and parallel talk were positively associated with stronger receptive and expressive language scores. The quality of evidence was not assessed as excellent for any of the included studies. Conclusions This systematic review reveals low-level evidence from 8 studies that specific language inputs (amount and style) are optimal for oral language outcomes in children with HL. Limitations were identified as sample selection bias, lack of information on control of confounders and assessment protocols, and limited duration of observation/recordings. Future research should address these limitations.

The Cantonese Hearing in Noise Test for Children.

The aim of this study was to develop a children's version of the Cantonese Hearing in Noise Test (CHINT-C). This was accomplished in two stages. First, a total of 120 sentences understood by children aged 6-7 years were selected from the original pool of CHINT sentences and were grouped into 12 lists, each containing 10 sentences composed of 10 characters. Following this, 260 primary and secondary school children, with ages ranging from 6 to 17 years, and 21 adults of age 18 or older were administered the CHINT-C to determine its reliability/validity, normative data, and age-specific correction factors. The result showed good interlist reliability, and test-retest reliability for the CHINT-C. The speech perception skills assessed using the CHINT-C do not reach adult level until after 11-13 years of age. Correction factors were established that could be used to determine age-specific norms for the evaluation of speech intelligibility of children in various sound fields.

Construction and evaluation of the Mandarin Chinese matrix (CMNmatrix) sentence test for the assessment of speech recognition in noise.

OBJECTIVE: Development of the Mandarin Chinese matrix (CMNmatrix) sentence test for speech intelligibility measurements in noise according to the international standard procedure. DESIGN: A 50-word base matrix representing the distribution of phonemes and lexical tones of spoken Mandarin was established. Hundred sentences capturing all the co-articulations of two consecutive words were recorded. Word-specific speech recognition functions, speech reception thresholds (SRT: signal-to-noise ratio (SNR), that provides 50% speech intelligibility) and slopes were obtained from measurements at fixed SNRs. The speech material was homogenised in intelligibility by applying level corrections up to ± 2 dB. Subsequently, the CMNmatrix test was evaluated, the comparability of test lists was measured at two fixed SNRs. To investigate the training effect and establish the reference data, speech recognition was measured adaptively. STUDY SAMPLE: Overall, the study sample contained 80 normal-hearing native Mandarin-speaking listeners. RESULTS: Multi-centre evaluation measurements confirmed that test lists are equivalent in intelligibility, with a mean SRT of -10.1 ± 0.1 dB SNR and a slope of 13.1 ± 0.9 %/dB. The reference SRT is -9.3 ± 0.8 and -11.2 ± 1.2 dB SNR for the open- and closed-set response format, respectively. CONCLUSION: The CMNmatrix test is suitable for accurate and internationally comparable speech recognition measurements in noise.