List Equivalency of the AzBio Sentence Test in Noise for Listeners with Normal-Hearing Sensitivity or Cochlear Implants

Department of Speech and Hearing Sciences, University of North Texas, USA.
Journal of the American Academy of Audiology (Impact Factor: 1.58). 07/2012; 23(7):501-9. DOI: 10.3766/jaaa.23.7.2
Source: PubMed


Speech recognition abilities of adults and children using cochlear implants (CIs) are significantly degraded in the presence of background noise, making this an important area of study and assessment by CI manufacturers, researchers, and audiologists. However, at this time there are a limited number of fixed-intensity sentence recognition tests available that also have multiple, equally intelligible lists in noise. One measure of speech recognition, the AzBio Sentence Test, provides 10-talker babble on the commercially available compact disc; however, there is no published evidence to support equivalency of the 15-sentence lists in noise for listeners with normal hearing (NH) or CIs. Furthermore, there is limited or no published data on the reliability, validity, and normative data for this test in noise for listeners with CIs or NH.
The primary goals of this study were to examine the equivalency of the AzBio Sentence Test lists at two signal-to-noise ratios (SNRs) in participants with NH and at one SNR for participants with CIs. Analyses were also conducted to establish the reliability, validity, and preliminary normative data for the AzBio Sentence Test for listeners with NH and CIs.
A cross-sectional, repeated measures design was used to assess speech recognition in noise for participants with NH or CIs.
The sample included 14 adults with NH and 12 adults or adolescents with Cochlear Freedom CI sound processors. Participants were recruited from the University of North Texas clinic population or from local CI centers. DATA COLLECTION and
Speech recognition was assessed using the 15 lists of the AzBio Sentence Test and the 10-talker babble. With the intensity of the sentences fixed at 73 dB SPL, listeners with NH were tested at 0 and -3 dB SNRs, and participants with CIs were tested at a +10 dB SNR. Repeated measures analysis of variance (ANOVA) was used to analyze the data.
The primary analyses revealed significant differences in performance across the 15 lists on the AzBio Sentence Test for listeners with NH and CIs. However, a follow-up analysis revealed no significant differences in performance across 10 of the 15 lists. Using the 10, equally-intelligible lists, a comparison of speech recognition performance across the two groups suggested similar performance between NH participants at a -3 dB SNR and the CI users at a +10 SNR. Several additional analyses were conducted to support the reliability and validity of the 10 equally intelligible AzBio sentence lists in noise, and preliminary normative data were provided.
Ten lists of the commercial version of the AzBio Sentence Test may be used as a reliable and valid measure of speech recognition in noise in listeners with NH or CIs. The equivalent lists may be used for a variety of purposes including audiological evaluations, determination of CI candidacy, hearing aid and CI programming considerations, research, and recommendations for hearing assistive technology. In addition, the preliminary normative data provided in this study establishes a starting point for the creation of comprehensive normative data for the AzBio Sentence Test.

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    • "The speech perception performance of cochlear implant (CI) users in quiet has continued to improve to a point where, for a significant number of recipients, open set speech understanding on sentence tests reaches 100% (Gifford et al., 2008). However, performance in noise is still an issue and when compared to normal hearing listeners; CI recipients still require significantly higher signal to noise ratios (SNRs) to achieve equivalent performance (Firszt et al., 2004; Schafer et al., 2012; Spahr and Dorman 2004). How to provide this improvement in performance in noise has become a major focus for both CI manufacturers and clinicians. "
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    ABSTRACT: Objectives To compare the Naida CI UltraZoom adaptive beamformer and T-Mic settings in a real life environment. Methods Speech reception thresholds (SRTs) were measured in a moderately reverberant room, using the German Oldenburger sentence test. The speech signal was always presented from the front loudspeaker at 0° azimuth and fixed masking noise was presented either simultaneously from all eight loudspeakers around the subject at 0°, ±45°, ±90°, ±135°, and 180° azimuth or from five loudspeakers positioned at ±70°, ±135°, and 180° azimuth. In the third test setup, an additional roving noise was added to the six loudspeaker arrangement. Results There was a significant difference in mean SRTs between the Naida CI T-Mic and UltraZoom in each of the three test setups. The largest improvements were seen in the six speaker roving and fixed noise conditions. Adding ClearVoice to the Naida CI T-Mic setting significantly improved the SRT in both fixed noise conditions, but not in the roving noise condition. In each setup, the lowest SRTs were obtained with the UltraZoom plus ClearVoice setting. Discussion The degree of improvement was consistent with previous beamforming studies. In the most challenging listening situation, with noise from eight speakers and speech and noise presented coincidentally from the front, UltraZoom still provided a significant benefit. When a moving noise source was added, the improvement in SRT provided by UltraZoom was maintained. Conclusion When tested in challenging and realistic noise environments, the Naida CI UltraZoom adaptive beamformer resulted in significantly lower mean SRTs than when the T-Mic alone was used.
    Cochlear Implants International 07/2014; 16(2). DOI:10.1179/1754762814Y.0000000088
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    ABSTRACT: Recently introduced frequency modulation (FM) systems provide an adaptive adjustment to the emphasis of the FM system through the user’s hearing aid via VoicePriority i™ (VPi). VPi measures the noise level at the listener’s hearing aid microphone and adds gain to the FM signal when the background noise increases to a detrimental level. However, the potential benefit of VPi technology has yet to be determined. Therefore, the goals of this investigation were to determine behavioral performance and subjective ratings with VPi as compared to traditional, fixed-gain FM systems or hearing aids alone. According to speech recognition performance in noise, VPi provided significantly better scores when compared to the traditional FM system in conditions with high levels of noise. Acceptable noise levels were also significantly better with VPi over the traditional FM system and the study hearing aids alone. Speech intelligibility ratings with both FM systems were significantly higher than ratings with study aids alone. Parent and child questionnaires yielded similar findings to the behavioral results, with significantly higher ratings for the FM system with VPi over the study and personal hearing aids alone. In conclusion, the FM systems with VPi provided superior performance and subjective ratings relative to traditional, fixed-gain FM systems or hearing aids alone.
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    ABSTRACT: Background: There is growing evidence in support of the cognitive remediation following cochlear implantation in children. To the best of our knowledge, the role of generalized cognitive training (CT) in adult cochlear implant users has not been explored. Objectives: To determine the effects of computerized CT with standard therapy on adult cochlear implant users‟ speech comprehension in noise, cognitive functions and auditory ability. Methods: A prospective, unblinded, single-center, randomized controlled trial with cross-over study design and two treatment arms. Participants (N = 12) from the Maritime Provinces in Canada received CT (via CogniFit) either right after the first assessment or ten weeks later in the immediate (n = 7) and delayed (n = 5) treatment groups respectively. Speech comprehension in noise, assessed by AzBio sentence test, was the primary outcome measure. The secondary outcomes were neuropsychological assessments - CANTABeclipse for Clinical Trials, and self-reported auditory ability - Speech Spatial Qualities questionnaire (SSQ). Data from 2 participants were excluded due to lack of follow-up, data from the remaining participants were analyzed by mixed models in SPSS (version 20) and R (version 3.0.2.). Results: Based upon analyses combined across two groups, CT with standard therapy (n = 10) marginally enhanced sentence comprehension in noise, AzBio score, β = 2.58, 95% CI [-2.84, 8.02], p > .05. Furthermore, CT demonstrated statistically significant, but modest improvement in SSQ total scores, β = 0.60, 95% CI [0.14, 1.05] and certain CANTABeclipse test scores. Namely, (i) SOC number of problems solved in minimum moves, β = 1.12, 95% CI [0.29, 1.94], for Spatial Planning (ii) SWM total errors for problems with 4 to 8 boxes, β = -11.32, 95% CI [-19.82, -2.81] and strategy, β = -3.08, 95% CI [-4.36, -1.81], for Spatial Working Memory, (iii) RVP A′, β = 0.015, 95% CI [0.005, 0.026], for Sustained Attention and (iv) VRM free recall, β = 1.25, 95% CI [0.25, 2.26] and recognition, β = 0.76, 95% CI [0.32, 1.20], for verbal memory. Conclusion: Ten weeks of cognitive training modestly enhanced executive and working memory skills in adult cochlear implant users. This finding suggests adult cochlear implant users‟ brains are malleable. The treatment effect estimates for speech comprehension in noise did not reach a statistically significant level. A longitudinal multicentered trial with a large sample size is needed to make evidence-based recommendation for the routine clinical care of cochlear implant users. Trial Registration: unique identifier NCT01732887
    05/2014, Degree: M.Phil. in International Community Health and Grad. Cert. in Translational NeuroTechnology 1, Supervisor: Gradmann Christoph, Lian Arild, Newman Aaron
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