提升儿童助听器使用者对低强度言语的可听度

文献信息

中文摘要

目的： 本研究旨在评估自适应增益增强器是否能显著改善在40和50 dBA下的轻声言语识别。
方法： 本研究为单组横断面干预研究，纳入20名9-12岁儿童和13名5-8岁感音神经性听力损失儿童。受试者佩戴研究用助听器，设置三种程序：带有言语增强器（SE）的安静环境程序，分别设为“中等”、“强”和“关闭”。在每个程序下于安静环境中以40和50 dBA完成辅音-核心-辅音（CNC）词识别测试。
结果： 在50 dBA下对SE关闭、中等和强三种条件进行的方差分析（ANOVA）显著，效应量较小：F(2) = 9.40（p ≤ .001；η2 = .16）。使用Bonferroni校正的事后比较发现，SE关闭与SE中等之间的平均CNC得分存在显著差异（p = .005，95%置信区间[CI, 1.79, 12.99]），SE关闭与SE强之间也存在显著差异（p < .001，95% CI [3.91, 15.11]），且两种条件下启用SE较关闭均有显著改善。在40 dBA下对三种SE条件另行进行的ANOVA也显著，效应量为中等：F(2) = 14.93，（p < .001，[公式：见正文]。使用Bonferroni校正的事后比较发现，SE关闭与SE中等之间的平均CNC得分存在显著差异（p < .001，95% CI [5.10, 20.12]），SE关闭与SE强之间也存在显著差异（p < .001，95% CI [8.50, 23.51]），启用SE时参与者的CNC得分高于关闭时。在40和50 dBA下，SE强与SE中等之间均未发现显著差异。
结论： 本研究提供证据表明，自适应低强度增益增强器可显著改善儿童对轻声言语的言语感知表现。可考虑在儿科患者中使用自适应低强度增益增强器以改善轻声言语的可听度。

英文摘要

PURPOSE: The purpose of the study was to evaluate whether an adaptive gain enhancer significantly improved soft speech recognition at 40 and 50 dBA.
METHOD: Twenty children, ages 9-12 years, and 13 children, ages 5-8 years, with sensorineural hearing loss were included in this single, cross-sectional group intervention study. They were fitted with study hearing aids with three programs: Calm Situation with Speech Enhancer (SE) set at "moderate," "strong," and "off." Consonant-nucleus-consonant (CNC) word recognition testing was completed with each program in quiet at 40 and 50 dBA.
RESULTS: An analysis of variance (ANOVA) for the three SE conditions off, moderate, and strong at 50 dBA was significant and had a small effect size: F(2) = 9.40 (p ≤ .001; η2 = .16). Post hoc comparisons using Bonferroni's correction found that mean CNC scores were significantly different between SE off and SE moderate (p = .005, 95% confidence interval [CI, 1.79, 12.99]) as well as SE off and SE strong (p < .001, 95% CI [3.91, 15.11]), and for both conditions, there was significant improvement with SE enabled versus off. A separate ANOVA for the three SE conditions at 40 dBA was also significant and had a medium effect: F(2) = 14.93, (p < .001, [Formula: see text]. Post hoc comparisons using Bonferroni's correction found that mean CNC scores were significantly different between SE off and SE moderate (p < .001, 95% CI [5.10, 20.12]) as well as SE off and SE strong (p < .001, 95% CI [8.50, 23.51]), with participants scoring higher on CNC when SE was enabled versus off. For both 40 and 50 dBA, there were no significant differences found between SE strong and SE moderate.
CONCLUSIONS: This study provides evidence that an adaptive, low-level gain enhancer significantly improves speech perception performance in children for soft speech. The use of an adaptive, low-level gain enhancer may be considered for use in pediatric patients to improve audibility for soft speech.